Organization Active NPI

Dr. Lavinia L Myers, PC

  • Psychiatry Physician
  • Burr Ridge, IL
National Provider Identifier
1346833753
Registry record updated Sep 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DR. LAVINIA L MYERS, PC
Practice address
16W281 83Rd St Ste B
Burr Ridge, IL 60527-7967
Phone
(630) 581-7798
Fax
(630) 581-7799
NPI assigned
Feb 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2021

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

Authorized official

Name
Lavinia Myers, MDNPI 1821194325
Title
President
Phone
(708) 860-7290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

16W281 83Rd St Ste B
Burr Ridge, IL 60527-7967

Mailing address

16W281 83Rd St Ste B
Burr Ridge, IL 60527-7967
Phone (630) 581-7798

Other practice location 1

8102 W 119th St Ste 1030
Palos Park, IL 60464-3081
Phone (708) 956-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240717001888 IL Part B Supplier - Clinic/Group Practice 0446795165 Receives reassigned benefits from 1 practitioner
Practice locations: Burr Ridge, IL

National Provider Directory

National Provider Directory

Locations

16W281 83rd St
Ste B
Burr Ridge, IL 60527
Phone (630) 581-7798

8102 W 119th St
Ste 1030
Palos Park, IL 60464
Phone (708) 381-0768

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631404800000",
    "number": "1346833753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16W281 83RD ST STE B",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277967",
            "telephone_number": "630-581-7798",
            "fax_number": "630-581-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16W281 83RD ST STE B",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277967",
            "telephone_number": "630-581-7798",
            "fax_number": "630-581-7799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8102 W 119th St Ste 1030",
            "address_purpose": "LOCATION",
            "city": "Palos Park",
            "state": "IL",
            "postal_code": "604643081",
            "country_code": "US",
            "telephone_number": "708-956-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. LAVINIA L MYERS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "LAVINIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-860-7290",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.