Active NPI
Olga Sergeevna Leavitt, M.D.
- Pediatric Anesthesiology Physician
- Chicago, IL
National Provider Identifier
1265798110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- 125061048
- Practice address
- 225 E Chicago Ave
Department of Anesthesiology, Box 19
Chicago, IL 60611-2991 - Phone
- (312) 227-5187
- NPI assigned
- Apr 4, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Anesthesiology Physician | 207LP3000X | 125061048 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Department of Anesthesiology, Box 19
Chicago, IL 60611-2991
Mailing address
420 E Superior St
Rubloff 12TH Floor
Chicago, IL 60611-4494
Phone (312) 503-7975
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
| License | State | Type | Specialty |
|---|---|---|---|
| 125061048 | IL | MD | Pediatric Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lurie Children's Medical Group, LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1265798110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 E SUPERIOR ST",
"address_2": "RUBLOFF 12TH FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114494",
"telephone_number": "312-503-7975",
"fax_number": "312-503-5230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY, BOX 19",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-5187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAVITT",
"first_name": "OLGA",
"middle_name": "SERGEEVNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-04",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "IL",
"license": "125061048",
"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 Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.