Individual provider Active NPI

Carlos Lara, MD

  • Neurology Physician
  • Chicago, IL
National Provider Identifier
1053816843
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036159062 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(773) 702-6222
NPI assigned
Mar 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 125072547 IL
Neurology Physician 2084N0400X 036159062 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240722000768 IL Practitioner - Neurology 5294084935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

Hospital & facility affiliations

  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088
  • Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191
  • Uchicago Medicine Northwest Indiana Hospital, Crown Point, IN, CCN 150195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Jul 1, 2024 Accepting new patients
University of Chicago CurrentSince Jul 1, 2024 Accepting new patients
Loyola University Medical Center Current Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 1, 2024 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

5758 S Maryland Ave
Chicago, IL 60637
Phone (773) 702-1865

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: clara231578@uchospital.direct-ci.com
  • Direct secure messaging: clara93377@direct.luhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1053816843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "125072547",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036159062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.