Individual provider Active NPI

Jack Lyons, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1104877851
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-090642 Issued in IL
Practice address
2900 N Lake Shore Dr
Chicago, IL 60657
Phone
(773) 665-3240
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-090642 IL Primary

Addresses

Primary practice location

2900 N Lake Shore Dr
Chicago, IL 60657

Mailing address

2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-3240

Other practice location 1

3101 N Harlem Ave
Chicago, IL 60634-4543
Phone (773) 836-9360

Other practice location 2

205 S Northwest Hwy Ste 110
Park Ridge, IL 60068-5802
Phone (773) 990-7684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100728001027 IL Practitioner - Diagnostic Radiology 0446143804 Reassigns benefits to 5 organizations
I20230829001669 MO Practitioner - Diagnostic Radiology 0446143804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians
Specialists in Medical Imaging SCGroup PAC ID 2163733544, 228 clinicians

Practice addresses (Care Compare)

1 Ingalls Dr
Harvey, IL 60426-3558
Phone (219) 767-6320

100 Medical Dr
Hannibal, MO 63401-6877
Phone (217) 223-8400

1005 Broadway St
Quincy, IL 62301-2834
Phone (309) 671-8282

4424 N Paulina St
Chicago, IL 60640-5306
Phone (219) 767-6320

4800 Maine St
Quincy, IL 62305-5875
Phone (217) 224-6423

600 S 13TH St
Pekin, IL 61554-4936
Phone (309) 671-8282

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-090642ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Partners of Iowa Inc Diagnostic Radiology CurrentSince May 24, 2024 Accepting new patients
Blessing Hospital CurrentSince Aug 1, 2023 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince Jun 19, 2023 Accepting new patients
Blessing Hospital CurrentSince Aug 1, 2023 Accepting new patients
Specialists in Medical Imaging SC Diagnostic Radiology CurrentSince Feb 1, 2019 Accepting new patients
Thorek Hospital and Medical Center Outpatient Pharmacy Current Accepting new patients
Thorek Memorial Hospital Current Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Franciscan Physician Network Past Accepting new patients
Chicago Imaging Associates, LLC Diagnostic Radiology Past Accepting new patients

Locations (25 of 29)

1001 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 472-4111

2741 Paysphere Cir
Chicago, IL 60674

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

3101 N Harlem Ave
Chicago, IL 60634
Phone (773) 836-9360

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

408 N 2nd St
Marshall, IL 62441
Phone (217) 826-2361

205 S Northwest Hwy
Ste 110
Park Ridge, IL 60068
Phone (773) 990-7684

205 S Northwest Hwy
Ste 120
Park Ridge, IL 60068
Phone (847) 292-5200

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

1005 Broadway St
Quincy, IL 62301

4800 Maine St
Quincy, IL 62305
Phone (217) 214-0444

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

3500 Franciscan Way
Michigan City, IN 46360
Phone (219) 852-1524

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

1104 E Grace St
Rensselaer, IN 47978
Phone (219) 866-2026

5500 S US Highway 41
Terre Haute, IN 47802
Phone (812) 238-4599

1429 N 6th St
Terre Haute, IN 47807
Phone (812) 242-3115

221 S 6th St
Terre Haute, IN 47807
Phone (812) 242-3157

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

2411 Laporte Ave
Valparaiso, IN 46383
Phone (219) 476-7226

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 12

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 7

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1104877851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-665-3240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 N Harlem Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606344543",
            "country_code": "US",
            "telephone_number": "773-836-9360",
            "fax_number": "773-914-2469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 S Northwest Hwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600685802",
            "country_code": "US",
            "telephone_number": "773-990-7684",
            "fax_number": "773-792-5124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-090642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.