Individual provider Active NPI

Glenn Arthur Lorentz, DO

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1295301927
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036167702 Issued in IL
Practice address
7447 W Talcott Ave Ste 216
Chicago, IL 60631-3713
Phone
(773) 631-0566
Fax
(773) 631-4436
NPI assigned
Jun 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036167702 IL Primary

Addresses

Primary practice location

7447 W Talcott Ave Ste 216
Chicago, IL 60631-3713

Mailing address

7447 W Talcott Ave Ste 216
Chicago, IL 60631-3713
Phone (773) 631-0566

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
I20240716002988 IL Practitioner - Family Practice 4385047083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Providers of Chicago SCGroup PAC ID 1759465636, 8 clinicians

Practice addresses (Care Compare)

7447 W Talcott Ave
Suite 216
Chicago, IL 60631-3713
Phone (773) 631-0566

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Providers of Chicago SC Family Medicine CurrentSince Aug 19, 2024 Accepting new patients

Locations

7447 W Talcott Ave
Ste 216
Chicago, IL 60631
Phone (312) 631-0566

150 N River Rd
Ste 100
Des Plaines, IL 60016
Phone (847) 298-0310

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.

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1295301927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE STE 216",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313713",
            "telephone_number": "773-631-0566",
            "fax_number": "773-631-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE STE 216",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313713",
            "telephone_number": "773-631-0566",
            "fax_number": "773-631-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENTZ",
        "first_name": "GLENN",
        "middle_name": "ARTHUR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036167702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.