Aisha Lane

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

AISHA LANE

Practice address

7900 W 75TH St
Bridgeview, IL 60455-1237

Phone

(708) 612-3956

Fax

(888) 265-5564

NPI assigned

Apr 18, 2019

Last updated

Jun 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pamela Clay

Title

Billing Manager

Phone

(888) 265-9908

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aisha Lane

  • Surgery Physician
  • Bridgeview, IL
  • NPI 1528498466

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1124681739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 W 73RD ST UNIT 922",
            "city": "BEDFORD PARK",
            "state": "IL",
            "postal_code": "604995332",
            "telephone_number": "708-612-3956",
            "fax_number": "888-265-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W 75TH ST",
            "city": "BRIDGEVIEW",
            "state": "IL",
            "postal_code": "604551237",
            "telephone_number": "708-612-3956",
            "fax_number": "888-265-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AISHA LANE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "888-265-9908"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Bridgeview, IL
• Providers in Bridgeview, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.