Active NPI
Bruce W. Lindgren, MD
- Pediatric Urology Physician
- Chicago, IL
National Provider Identifier
1346275492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Urology Physician
- License
- 036085394
- Practice address
- 225 E Chicago Ave # 24
Chicago, IL 60611 - Phone
- (312) 227-4000
- NPI assigned
- Jul 11, 2006
- Last updated
- May 22, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 036085394 | IL | |
| Pediatric Urology Physician | 2088P0231X | 036085394 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave # 24
Chicago, IL 60611
Mailing address
225 E Chicago Ave # 24
Chicago, IL 60611-2991
Phone (312) 227-4000
Other practice location 1
225 E Chicago Ave # 24
Chicago, IL 60611
Phone (312) 227-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036085394 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036085394 | IL | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lurie Children's Medical Group, LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590105600000",
"number": "1346275492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE # 24",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE # 24",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-227-4000"
}
],
"practiceLocations": [
{
"address_1": "225 E Chicago Ave # 24",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60611",
"country_code": "US",
"telephone_number": "312-227-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LINDGREN",
"first_name": "BRUCE",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "036085394",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "IL",
"license": "036085394",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036085394",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.