Katharyn Desa Lupo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036138404 Issued in IL

Practice address

636 Raymond Dr
Naperville, IL 60563-9789

Phone

(630) 922-2350

Fax

(630) 922-2070

NPI assigned

Apr 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Katharyn Desa Freund Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1295979300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-922-2350",
            "fax_number": "630-922-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-922-2350",
            "fax_number": "630-922-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPO",
        "first_name": "KATHARYN",
        "middle_name": "DESA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036138404",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD448210",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036138404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036138404",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP",
            "identifier": "920540",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN INDIVIDUAL",
            "identifier": "F400228991",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHARYN",
            "last_name": "FREUND",
            "middle_name": "DESA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra Lukashevich, LCPC
• Katelyn Elizabeth Ann Lukensmeyer, LCSW
• Eric James Lukosus, D.C.
• Mira Lukyana, LSW
• Andrew J Lunardini
• Kathleen M. Lutgen, CCC-SP
• Luxottica of America Inc
• Abigail Lynch, M.S. CCC-SLP
• Christina R Lyon, D.O.
• Paul B Lyon, MD

• Internal Medicine Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.