Individual provider Active NPI

Beth Ledvora, M.D.

  • Psychiatry Physician
  • Palos Heights, IL
National Provider Identifier
1104993161
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-073475 Issued in IL
Practice address
7808 W College Dr Ste 2W
Palos Heights, IL 60463-1098
Phone
(708) 361-5110
Fax
(708) 361-5305
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-073475 IL Primary

Addresses

Primary practice location

7808 W College Dr Ste 2W
Palos Heights, IL 60463-1098

Mailing address

7808 W College Dr Ste 2W
Palos Heights, IL 60463-1098
Phone (708) 361-5110

Other identifiers 1

IdentifierTypeStateIssuer
036073475MedicaidIL

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
I20090212000223 IL Practitioner - Psychiatry 4789749466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Northwestern University Feinberg Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Ledvora MD SCGroup PAC ID 4587898754, 7 clinicians

Practice addresses (Care Compare)

7808 W College Dr
Suite 2
Palos Heights, IL 60463-1027
Phone (708) 361-5110

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
21.85 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-073475ILMDPsychiatry Physician

Organizations & group practices 1

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 2

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1104993161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7808 W COLLEGE DR STE 2W",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631098",
            "telephone_number": "708-361-5110",
            "fax_number": "708-361-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7808 W COLLEGE DR STE 2W",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631098",
            "telephone_number": "708-361-5110",
            "fax_number": "708-361-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDVORA",
        "first_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-073475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073475",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.