Individual provider Active NPI

Kathleen Marisa Laslo, M.D., MPH

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1215057773
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036116369 Issued in IL
Practice address
1701 W Superior St
Chicago, IL 60622-5646
Phone
(312) 666-3494
Fax
(312) 666-6228
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036116369 IL Primary

Addresses

Primary practice location

1701 W Superior St
Chicago, IL 60622-5646

Mailing address

4937 N Christiana Ave
Chicago, IL 60625-5003
Phone (773) 750-1513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036116369ILMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: klaslo368600@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1215057773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4937 N CHRISTIANA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606255003",
            "telephone_number": "773-750-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225646",
            "telephone_number": "312-666-3494",
            "fax_number": "312-666-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASLO",
        "first_name": "KATHLEEN",
        "middle_name": "MARISA",
        "name_prefix": "Dr.",
        "credential": "M.D., MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036116369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.