Individual provider Active NPI

Laura J Louthain-Walrod, M.D.

  • Pediatrics Physician
  • McHenry, IL
National Provider Identifier
1306804109
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036105822 Issued in IL
Practice address
4201 W Medical Center Dr
McHenry, IL 60050
Phone
(815) 344-5000
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036105822 IL Primary

Addresses

Primary practice location

4201 W Medical Center Dr
McHenry, IL 60050

Mailing address

3707 Doty Road, Ste F
Attn: Credentialing
Woodstock, IL 60098
Phone (815) 338-6600

Other practice location 1

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (224) 654-0000

Other practice location 2

3701 Doty Rd
Woodstock, IL 60098-7509
Phone (815) 338-2500

Other identifiers 2

IdentifierTypeStateIssuer
036105822OtherILSTATE LICENSE
962341OtherILMEDICARE

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
I20100115000525 IL Practitioner - Pediatric Medicine 2567504434 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Pediatrics CurrentSince May 1, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Specialty Physicians of Illinois, LLC Pediatrics Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

4309 W Medical Center Dr
Ste B310
McHenry, IL 60050
Phone (847) 802-7090

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

3701 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

3707 Doty Rd
Ste F
Woodstock, IL 60098

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1306804109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 DOTY ROAD, STE F",
            "address_2": "ATTN: CREDENTIALING",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "60098",
            "telephone_number": "815-338-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "815-344-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429553",
            "country_code": "US",
            "telephone_number": "224-654-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3701 Doty Rd",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600987509",
            "country_code": "US",
            "telephone_number": "815-338-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUTHAIN-WALROD",
        "first_name": "LAURA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036105822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036105822",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "962341",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.