Fausto R. Lora-Mir, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036084051 Issued in IL

Practice address

2023 Royal Blvd
Suite a
Elgin, IL 60120

Phone

(847) 931-7274

Fax

(847) 931-7159

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1104875434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 ROYAL BLVD",
            "address_2": "SUITE A",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-931-7274",
            "fax_number": "847-931-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 ROYAL BLVD",
            "address_2": "SUITE A",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-931-7274",
            "fax_number": "847-931-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORA-MIR",
        "first_name": "FAUSTO",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036084051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084051",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005767635",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0163557",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "00001384212 18",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaela Sasheva Long
• Josh Lopez
• Ruby Lopez, APRN
• Sara Margaret Lopez, PA-C
• Yesenia Lopez
• Loretta C. Davis, D.D.S. & Associates (Spring Hill), LTD.
• Los Quiropracticos, LLC
• Joseph Losurdo, MD
• Katherine Lottermoser
• Kenya Love

• Internal Medicine Physician in Elgin, IL
• Providers in Elgin, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.