Individual provider Active NPI

Lubov A Klemine, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1124228853
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036105632 Issued in IL
Practice address
2222 W Division St
Suite 200
Chicago, IL 60622-2717
Phone
(773) 395-8444
Fax
(773) 395-8400
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036105632 IL Primary

Addresses

Primary practice location

2222 W Division St
Suite 200
Chicago, IL 60622-2717

Mailing address

1800 Harrison St
Glenview, IL 60025-5004
Phone (773) 395-8444

Other identifiers 1

IdentifierTypeStateIssuer
036105632MedicaidIL

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
I20041026000913 IL Practitioner - Family Practice 3375504129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2222 W Division St
Suite 200
Chicago, IL 60622-3094
Phone (773) 395-8444

Hospital & facility affiliations

  • Senior Home Health Agency Home health agency, Park Ridge, IL, CCN 148059
  • Presence Saints Mary and Elizabeth Medical Center Hospital, Chicago, IL, CCN 140180
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036105632ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of North Chicago, LTD Single Specialty CurrentSince Jan 1, 2005 Accepting new patients

Locations

2222 W Division St
Ste 200
Chicago, IL 60622
Phone (773) 342-5781

903 N Western Ave
Chicago, IL 60622
Phone (773) 227-5707

325 N Milwaukee Ave
Ste E
Wheeling, IL 60090

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 3

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1124228853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600255004",
            "telephone_number": "773-395-8444",
            "fax_number": "773-395-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-395-8444",
            "fax_number": "773-395-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMINE",
        "first_name": "LUBOV",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036105632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105632",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.