Individual provider Active NPI

Peter Lourgos, M.D.

  • Psychiatry Physician
  • Niles, IL
National Provider Identifier
1073644092
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-105249 Issued in IL
Practice address
7447 W Lawler Ave
Niles, IL 60714-3107
Phone
(855) 629-0554
Fax
(888) 947-7879
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 61262 TN
Psychiatry Physician 2084P0800X 11699556-1205 UT
Psychiatry Physician 2084P0800X 35677 OK
Psychiatry Physician 2084P0800X 19711 NV
Psychiatry Physician 2084P0800X D89075 MD
Psychiatry Physician 2084P0800X 32439 NE
Psychiatry Physician 2084P0800X 67019 MN
Psychiatry Physician 2084P0800X MD61053703 WA
Psychiatry Physician 2084P0800X 04-43064 KS
Psychiatry Physician 2084P0800X 525-320 WI
Psychiatry Physician 2084P0800X MD-47140 IA
Psychiatry Physician 2084P0800X 60849 AZ
Psychiatry Physician 2084P0800X MED-PHYS-LIC-85278 MT
Psychiatry Physician 2084P0800X CDR.0000659 CO
Psychiatry Physician 2084P0800X 036-105249 IL Primary

Addresses

Primary practice location

7447 W Lawler Ave
Niles, IL 60714-3107

Mailing address

7447 W Lawler Ave
Niles, IL 60714-3107
Phone (708) 719-1695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60849AZMDPsychiatry Physician
CDR.0000659COMDPsychiatry Physician
MD-47140IAMDPsychiatry Physician
036-105249ILMDPsychiatry Physician
04-43064KSMDPsychiatry Physician
D89075MDMDPsychiatry Physician
67019MNMDPsychiatry Physician
MED-PHYS-LIC-85278MTMDPsychiatry Physician
32439NEMDPsychiatry Physician
19711NVMDPsychiatry Physician
35677OKMDPsychiatry Physician
61262TNMDPsychiatry Physician
11699556-1205UTMDPsychiatry Physician
MD61053703WAMDPsychiatry Physician
525-320WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Family Services Past Accepting new patients
Metropolitan Family Services Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1073644092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W LAWLER AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143107",
            "telephone_number": "708-719-1695",
            "fax_number": "888-947-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W LAWLER AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143107",
            "telephone_number": "855-629-0554",
            "fax_number": "888-947-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOURGOS",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "61262",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "11699556-1205",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "35677",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "19711",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D89075",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "32439",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "67019",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61053703",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "04-43064",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "525-320",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "MD-47140",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "60849",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MT",
            "license": "MED-PHYS-LIC-85278",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "CDR.0000659",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-105249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.