Individual provider Active NPI

Lauren Duane Buckingham, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1093109803
Registry record updated Oct 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.005383 Issued in IL
Practice address
1449 W Irving Park Rd
Chicago, IL 60613-1922
Phone
(872) 315-3375
NPI assigned
Mar 19, 2015
Last updated
Oct 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.005383 IL Primary

Addresses

Primary practice location

1449 W Irving Park Rd
Chicago, IL 60613-1922

Mailing address

3740 N Halsted St Apt 1224
Chicago, IL 60613-5611
Phone (872) 315-3375

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150615001794 IL Practitioner - Physician Assistant 1951612175 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

3909 N Western Ave
Chicago, IL 60618-3741
Phone (773) 739-9200

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.005383ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Jan 1, 2020 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jan 1, 2020 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Jan 1, 2025 Accepting new patients
Vitality Group Inc PastSince Jun 1, 2016 Accepting new patients
Dental Medical Services Inc. Past Accepting new patients
Vitality Home Health Services,Inc. PastSince Oct 1, 2016 Accepting new patients

Locations

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

1840 N Richmond Rd
#M
McHenry, IL 60051

1190 S Naper Blvd
Naperville, IL 60540
Phone (312) 229-0345

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 8

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": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791590400000",
    "number": "1093109803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 N HALSTED ST APT 1224",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135611",
            "telephone_number": "872-315-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131922",
            "telephone_number": "872-315-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "LAUREN",
        "middle_name": "DUANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-19",
        "last_updated": "2026-10-10",
        "certification_date": "2026-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.