NPIMap

Individual provider Active NPI

Lori Ann Knutstrom, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Onarga, IL
National Provider Identifier
1295817054
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016-004332 Issued in IL
Practice address
912 W Seminary Ave
Onarga, IL 60955-1401
Phone
(815) 268-4840
Fax
(815) 268-4845
NPI assigned
Oct 20, 2006
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016-004332 IL Primary

Addresses

Primary practice location

912 W Seminary Ave
Onarga, IL 60955-1401

Mailing address

PO Box 985
New Lenox, IL 60451
Phone (815) 325-5975

Other practice location 1

705 S Dixie Hwy
Hoopeston, IL 60942-1904
Phone (217) 283-5530

Other practice location 2

806 E Walnut St
Watseka, IL 60970-1583
Phone (815) 432-1078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110214000029 IL Practitioner - Podiatry 5991985673 Reassigns benefits to 1 organization
Practice locations: Tinley Park, IL; Joliet, IL; Shorewood, IL; Romeoville, IL; Orland Park, IL; New Lenox, IL; Loda, IL; Crest Hill, IL…

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

705 S Dixie Hwy
Hoopeston, IL 60942-1904
Phone (217) 283-5530

806 E Walnut St
Suite a
Watseka, IL 60970-1584
Phone (815) 432-1078

912 W Seminary Ave
Onarga, IL 60955-1401
Phone (815) 268-4840

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-004332ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince Nov 9, 2020 Accepting new patients
Gibson Community Hospital Association CurrentSince Nov 9, 2020 Accepting new patients

Locations

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

705 S Dixie Hwy
Hoopeston, IL 60942
Phone (217) 283-5530

912 W Seminary Ave
Onarga, IL 60955
Phone (815) 268-4840

806 E Walnut St
Watseka, IL 60970
Phone (815) 432-1078

806 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-1078

Interoperability endpoints

  • Direct secure messaging: lori.knutstrom.p10@direct.gapho.nextgenshare.com
  • Direct secure messaging: lori.knutstrom.p44@direct.gapho.nextgenshare.com
  • Direct secure messaging: lori.knutstrom.p6@direct.gapho.nextgenshare.com

Organizations & group practices 3

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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1295817054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 985",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-325-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 W SEMINARY AVE",
            "city": "ONARGA",
            "state": "IL",
            "postal_code": "609551401",
            "telephone_number": "815-268-4840",
            "fax_number": "815-268-4845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 S Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Hoopeston",
            "state": "IL",
            "postal_code": "609421904",
            "country_code": "US",
            "telephone_number": "217-283-5530",
            "fax_number": "217-283-6437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "806 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Watseka",
            "state": "IL",
            "postal_code": "609701583",
            "country_code": "US",
            "telephone_number": "815-432-1078",
            "fax_number": "815-432-1079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNUTSTROM",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-004332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onarga, IL

Sources for this page

Verify at the official NPI Registry.