NPIMap

Individual provider Active NPI

Lawrence Merion Lavine, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Crystal Lake, IL
National Provider Identifier
1336119171
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036049364 Issued in IL
Practice address
1 S Virginia St
Crystal Lake, IL 60014-5826
Phone
(260) 414-4990
NPI assigned
Jan 24, 2006
Last updated
Dec 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-049364 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036049364 IL Primary

Addresses

Primary practice location

1 S Virginia St
Crystal Lake, IL 60014-5826

Mailing address

1 S Virginia St
Crystal Lake, IL 60014-5826
Phone (260) 414-4990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-049364ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Anesthesia PC Past Accepting new patients
Northeast Indiana Anesthesiology, PC Anesthesiology Past Accepting new patients
Atlanticare Regional Medical Center Anesthesiology Past Accepting new patients
Sheridan Healthcare of Indiana PC Anesthesiology Past Accepting new patients
Windy City Anesthesia PC Anesthesiology Past Accepting new patients
Anesthetix of Bradford, LLC Anesthesiology Past Accepting new patients
St. Joseph Primary Care, LLC Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1336119171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600145826",
            "telephone_number": "260-414-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600145826",
            "telephone_number": "260-414-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE",
        "first_name": "LAWRENCE",
        "middle_name": "MERION",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-049364",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036049364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.