Individual provider Active NPI

Jason Lafave

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1083274997
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036164445 Issued in IL
Practice address
1801 W Taylor St Ste 2E
Chicago, IL 60612-4795
Phone
(312) 996-7416
NPI assigned
Jun 13, 2019
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036164445 IL Primary

Addresses

Primary practice location

1801 W Taylor St Ste 2E
Chicago, IL 60612-4795

Mailing address

1801 W Taylor St Ste 2E
Chicago, IL 60612-4795
Phone (312) 996-7416

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
I20231205003734 IL Practitioner - Pediatric Medicine 1557789229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Oct 28, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Oct 28, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients

Locations

1801 W Taylor St
Ste 2E
Chicago, IL 60612
Phone (312) 996-7416

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

Interoperability endpoints

  • Direct secure messaging: jlafave69344@uihealth.direct-ci.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1083274997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST STE 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-996-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST STE 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-996-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFAVE",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036164445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.