Individual provider Active NPI

Elizabeth Amanda Lippner, M.D.

  • Allergy & Immunology Physician
  • Chicago, IL
National Provider Identifier
1295179497
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
036.151019 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-4000
NPI assigned
Apr 18, 2013
Last updated
Jan 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Allergy & Immunology Physician 207K00000X 036.151019 IL Primary
Pediatrics Physician 208000000X A135609 CA

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

225 E Chicago Ave
Chicago, IL 60611-2991

Other practice location 1

757 Westwood Plz
B711 Rrumc
Los Angeles, CA 90095-7419
Phone (310) 267-9129

Other practice location 2

269 Campus Drive CCSR Building
Suite 3215
Stanford, CA 94305
Phone (650) 498-6074

Other names 1

  • Elizabeth Amanda Loo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180926002079 CA Practitioner - Pediatric Medicine 9739430059 Reassigns benefits to 1 organization
I20200319001328 IL Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 9739430059 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.151019ILMDAllergy & Immunology Physician
A135609CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Confermed of California PC CurrentSince May 1, 2024 Accepting new patients
Lurie Children's Medical Group Inc Pediatrics CurrentSince Feb 10, 2020 Accepting new patients
Confermed PC Pediatrics Past Accepting new patients
Lurie Children's Medical Group, LLC Pediatrics Past Accepting new patients

Locations

101 Academy
Ste 100
Irvine, CA 92617
Phone (860) 323-0172

11 Silver St
Unit 856
Middletown, CT 06457

Claims Remittance
Carol Stream, IL 60122

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

Interoperability endpoints

  • Direct secure messaging: elizabeth.lippner.1@11074.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1295179497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz",
            "address_2": "B711 RRUMC",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900957419",
            "country_code": "US",
            "telephone_number": "310-267-9129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "269 Campus Drive CCSR Building",
            "address_2": "Suite 3215",
            "address_purpose": "LOCATION",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "country_code": "US",
            "telephone_number": "650-498-6074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPPNER",
        "first_name": "ELIZABETH",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036.151019",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A135609",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LOO",
            "middle_name": "AMANDA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.