Active NPI
Lazaros Pavlidis, MD
- Surgery Physician
- Chicago, IL
National Provider Identifier
1235653783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125.071319
- Practice address
- 836 West Wellington Avenue
Chicago, IL 60657 - Phone
- (773) 975-1600
- NPI assigned
- Jul 26, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 125.071319 | IL | Primary |
Addresses
Primary practice location
836 West Wellington Avenue
Chicago, IL 60657
Mailing address
836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.071319 | IL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1235653783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 W WELLINGTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575147",
"telephone_number": "773-975-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "836 WEST WELLINGTON AVENUE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60657",
"telephone_number": "773-975-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVLIDIS",
"first_name": "LAZAROS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125.071319",
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.