Individual provider Active NPI

Lawrence Ngu, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1114081643
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-092049 Issued in IL
Practice address
2545 S King Dr
Chicago, IL 60616-2441
Phone
(312) 842-7117
NPI assigned
Dec 20, 2006
Last updated
Aug 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-092049 IL Primary
General Practice Physician 208D00000X 036-092049 IL

Addresses

Primary practice location

2545 S King Dr
Chicago, IL 60616-2441

Mailing address

2311 W 22ND St
Suite 202
Oak Brook, IL 60523-1225

Other identifiers 1

IdentifierTypeStateIssuer
036092049MedicaidIL

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
I20040817001289 IL Practitioner - Internal Medicine 0941273916 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-092049ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanni Supportive Living CurrentSince Jun 1, 2023 Accepting new patients
Cook County Current Accepting new patients
Cook County Internal Medicine CurrentSince Nov 10, 2010 Accepting new patients
Cook County CurrentSince Nov 10, 2010 Accepting new patients
Elite Treatment Center CurrentSince Aug 30, 2025 Accepting new patients
Solid Rock Care Center II General Practice Past Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

25706 Network Pl
Chicago, IL 60673

4909 W Division St
Chicago, IL 60651
Phone (773) 854-8000

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1800 Nations Dr
Ste 119
Gurnee, IL 60031
Phone (847) 868-3003

Organizations & group practices 6

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1114081643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 W 22ND ST",
            "address_2": "SUITE 202",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162441",
            "telephone_number": "312-842-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGU",
        "first_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-092049",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036-092049",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092049",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.