Individual provider Active NPI

Lance D Holemon, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1215056296
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036076493 Issued in IL
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 421-4821
Fax
(312) 421-4208
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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 036076493 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

1335 W Chicago Ave
Chicago, IL 60622-5761
Phone (312) 421-4821

Other identifiers 3

IdentifierTypeStateIssuer
31603527OtherILBCBS ILLINOIS
P00130149OtherRAILROAD MEDICARE
036076493MedicaidIL

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
I20060410000088 IL Practitioner - Psychiatry 1951310622 Reassigns benefits to 1 organization
Practice locations: Niles, IL; Glenview, IL; Des Plaines, IL; Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Missouri, Columbia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1620 W Harrison St
Chicago, IL 60612-3801

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Nov 1, 2020 Accepting new patients
Rush University Medical Center CurrentSince Nov 1, 2020 Accepting new patients
Fernando Hernandez MD SC PastSince Jul 20, 2006 Accepting new patients
University Anesthesiologists SC Past Accepting new patients
Associates in Behavioral Health S C Psychiatry Past Accepting new patients

Locations

2150 W Harrison St
Chicago, IL 60612
Phone (312) 563-1212

1725 W Harrison St
Ste 843
Chicago, IL 60612
Phone (312) 942-2356

66 W Oak St
Chicago, IL 60610
Phone (312) 337-5400

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 837
Chicago, IL 60612
Phone (312) 942-6013

Interoperability endpoints

  • Direct secure messaging: lholemon4801@direct.rush.rush-health.com

Organizations & group practices 5

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1215056296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225761",
            "telephone_number": "312-421-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-421-4821",
            "fax_number": "312-421-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLEMON",
        "first_name": "LANCE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036076493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ILLINOIS",
            "identifier": "31603527",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00130149",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036076493",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.