Individual provider Active NPI

Lauren Victoria Kyrouac

  • Physician Assistant
  • Glenview, IL
National Provider Identifier
1326668492
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008171 Issued in IL
Practice address
2701 Patriot Blvd
Glenview, IL 60026-8039
Phone
(847) 535-8500
Fax
(847) 998-9303
NPI assigned
Apr 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085008171 IL Primary

Addresses

Primary practice location

2701 Patriot Blvd
Glenview, IL 60026-8039

Mailing address

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 535-8500

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
I20210426001869 IL Practitioner - Physician Assistant 5799193033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500

1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

1200 N Westmoreland Rd
Suite 100
Lake Forest, IL 60045-1601
Phone (847) 735-8500

1475 E Belvidere Rd
Grayslake, IL 60030-2012

600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Apr 17, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Apr 17, 2021 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536

1475 E Belvidere Rd
Ste 185
Grayslake, IL 60030
Phone (847) 534-3278

1000 N Westmoreland Rd
#3
Lake Forest, IL 60045
Phone (847) 535-8500

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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.

Hospital & facility affiliations 1

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": "1587254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1326668492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268039",
            "telephone_number": "847-535-8500",
            "fax_number": "847-998-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268039",
            "telephone_number": "847-535-8500",
            "fax_number": "847-998-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYROUAC",
        "first_name": "LAUREN",
        "middle_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-19",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.