Individual provider Active NPI

Lauren Sarah Kramer, PA-C

  • Surgical Physician Assistant
  • Westchester, IL
National Provider Identifier
1306174107
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085-003639 Issued in IL
Practice address
3 Westbrook Corporate Ctr
Ste 100
Westchester, IL 60154-5703
Phone
(708) 343-3566
Fax
(708) 409-1429
NPI assigned
Dec 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085-003639 IL Primary

Addresses

Primary practice location

3 Westbrook Corporate Ctr
Ste 100
Westchester, IL 60154-5703

Mailing address

3 Westbrook Corporate Ctr
Ste 100
Westchester, IL 60154-5703
Phone (708) 343-3566

Other identifiers 2

IdentifierTypeStateIssuer
085003639MedicaidIL
1632283OtherILBLUE CROSS BLUE SHIELD

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317000082 IL Practitioner - Physician Assistant 6901931955 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-003639ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 5, 2022 Accepting new patients
Gottlieb Community Health Services Corporation Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1306174107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WESTBROOK CORPORATE CTR",
            "address_2": "STE 100",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545703",
            "telephone_number": "708-343-3566",
            "fax_number": "708-409-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WESTBROOK CORPORATE CTR",
            "address_2": "STE 100",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545703",
            "telephone_number": "708-343-3566",
            "fax_number": "708-409-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "LAUREN",
        "middle_name": "SARAH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085-003639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085003639",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1632283",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westchester, IL

Sources for this page

Verify at the official NPI Registry.