Individual provider Active NPI

Katherine Louise Maietta, M.D.

  • Internal Medicine Physician
  • Oak Park, IL
National Provider Identifier
1275799710
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.128371 Issued in IL
Practice address
1010 Lake St Ste 301
Oak Park, IL 60301-1133
Phone
(708) 524-8600
Fax
(708) 524-8147
NPI assigned
Aug 4, 2008
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.128371 IL Primary
Pediatrics Physician 208000000X 036.128371 IL

Addresses

Primary practice location

1010 Lake St Ste 301
Oak Park, IL 60301-1133

Mailing address

1010 Lake St Ste 301
Oak Park, IL 60301-1133
Phone (708) 524-8600

Other practice location 1

1645 W Jackson Blvd Ste 215
Chicago, IL 60612-3227
Phone (312) 942-3034

Other practice location 2

738 N Lombard Ave
Oak Park, IL 60302-1722
Phone (708) 524-8147

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address frontdesk@lakestreetfamily.com Health Information Exchange (HIE)

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
I20120924000397 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6709034333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Pennsylvania State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Street Family Physicians SC IncGroup PAC ID 8123081189, 8 clinicians

Practice addresses (Care Compare)

1010 Lake St
Suite 301
Oak Park, IL 60301-1133
Phone (708) 524-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.58 of 100Reported as group
Quality
68.78
Promoting interoperability
100
Improvement activities
40
Cost
73.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.128371ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Lake Street Family Physicians SC Inc CurrentSince Mar 25, 2024 Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

1010 Lake St
Ste 301
Oak Park, IL 60301
Phone (708) 524-8600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFAFDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HFAFDD/Endpoint/HFAFDD
  • Direct secure messaging: kmaietta48064@direct.luhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1275799710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 301",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011133",
            "telephone_number": "708-524-8600",
            "fax_number": "708-524-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 301",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011133",
            "telephone_number": "708-524-8600",
            "fax_number": "708-524-8147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 W Jackson Blvd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123227",
            "country_code": "US",
            "telephone_number": "312-942-3034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "738 N Lombard Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603021722",
            "country_code": "US",
            "telephone_number": "708-524-8147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAIETTA",
        "first_name": "KATHERINE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.128371",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.128371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frontdesk@lakestreetfamily.com",
            "affiliation": "N",
            "endpointDescription": "front desk",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 Lake St Ste 301",
            "city": "Oak Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "603011133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.