Individual provider Active NPI

Lauren Emily Koch Macdonald, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1245643063
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019029947 Issued in IL
Practice address
2896 N Milwaukee Ave
Chicago, IL 60618-7413
Phone
(773) 295-6439
Fax
(773) 295-6690
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019029947 IL Primary

Addresses

Primary practice location

2896 N Milwaukee Ave
Chicago, IL 60618-7413

Mailing address

2450 N Avers Ave
Chicago, IL 60647-2224
Phone (517) 673-1967

Other practice location 1

3800 N Pulaski Rd
Chicago, IL 60641
Phone (773) 663-3800

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222002729 IL Order and Referring Only - DentistPractitioner - Dentist 8628379310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren E Koch DDS PC CurrentSince Aug 25, 2024 Accepting new patients
Simon and Simon, P.C. General Practice Past Accepting new patients
Kinnery Patel, DDS, LTD. PastSince Dec 28, 2025 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1245643063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 N AVERS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472224",
            "telephone_number": "517-673-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2896 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187413",
            "telephone_number": "773-295-6439",
            "fax_number": "773-295-6690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 N Pulaski Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60641",
            "country_code": "US",
            "telephone_number": "773-663-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH MACDONALD",
        "first_name": "LAUREN",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.