Active NPI
Lisa M Parker-Davis, MD
- Pediatrics Physician
- Chicago, IL
National Provider Identifier
1215971171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036092030
- Practice address
- 225 E Chicago Ave
Chicago, IL 60611-2991 - Phone
- (312) 227-4000
- NPI assigned
- Jun 15, 2006
- Last updated
- Jan 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036092030 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
10608 S Wood St
Chicago, IL 60643-2718
Phone (773) 779-3623
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036092030 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lurie Children's Medical Group, LLC | Pediatrics | Past | Accepting new patients |
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, 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": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516838400000",
"number": "1215971171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10608 S WOOD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606432718",
"telephone_number": "773-779-3623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER-DAVIS",
"first_name": "LISA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2018-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036092030",
"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 Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.