Individual provider Active NPI

Victor Lichtenberg, DO

  • Anesthesiology Physician
  • Park Ridge, IL
National Provider Identifier
1255413225
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036064608 Issued in IL
Practice address
1775 W. Dempster
Park Ridge, IL 60068
Phone
(847) 723-2210
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036064608 IL Primary

Addresses

Primary practice location

1775 W. Dempster
Park Ridge, IL 60068

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address vlichtenberg250874@direct.myadvocateaurora.org Direct

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
I20040303000489 IL Practitioner - Anesthesiology 1254243819 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Chicago College of Osteopathy, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Anesthesia Partners LLCGroup PAC ID 6204737596, 117 clinicians

Practice addresses (Care Compare)

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-2210

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Midwest Anesthesia Partners, LLC Anesthesiology CurrentSince Sep 1, 2014 Accepting new patients
United Shockwave Services, LTD. Anesthesiology CurrentSince Oct 7, 2008 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Oct 29, 2023 Accepting new patients
United Shockwave Services, LTD. Anesthesiology Current Accepting new patients
Illinois Gastroenterology Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
United Shockwave Services, LTD. CurrentSince Oct 7, 2008 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 29, 2023 Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

29373 Network Pl
Chicago, IL 60673

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

2551 Compass Rd
Ste 115
Glenview, IL 60026
Phone (847) 656-2400

1900 Hollister Dr
Ste 100
Libertyville, IL 60048
Phone (847) 367-8100

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

6701 159th St
Tinley Park, IL 60477
Phone (708) 429-0222

Organizations & group practices 11

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1255413225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W. DEMPSTER",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-723-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENBERG",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036064608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vlichtenberg250874@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.