Individual provider Active NPI

Lauren H. Le, D.D.S

  • Dentist
  • Chicago, IL
National Provider Identifier
1366637902
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019024555 Issued in IL
Practice address
1276 N Clybourn Ave
Chicago, IL 60610-2003
Phone
(312) 337-1073
Fax
(312) 337-7616
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019-024555 IL
Dentist 122300000X 019024555 IL Primary

Addresses

Primary practice location

1276 N Clybourn Ave
Chicago, IL 60610-2003

Mailing address

1276 N Clybourn Ave
Chicago, IL 60610-2003
Phone (312) 337-1073

Other practice location 1

7648 N Paulina St
Chicago, IL 60626-1018
Phone (773) 262-6622

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828004030 IL Practitioner - Dentist 9638670987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1276 N Clybourn Ave
Chicago, IL 60610-2089

1461 Crestview Rd
Redlands, CA 92374-6341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-024555ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Near North Health Service Corporation CurrentSince Jun 1, 2025 Accepting new patients
Near North Health Service Corporation CurrentSince Jun 1, 2025 Accepting new patients
Near North Health Service Corporation Current Accepting new patients
Howard Area Commuity Center Past Accepting new patients

Locations

3753 S Cottage Grove Ave
Chicago, IL 60653
Phone (773) 268-7600

1276 N Clybourn Ave
Chicago, IL 60610
Phone (312) 337-1073

4259 S Berkeley Ave
Chicago, IL 60653
Phone (773) 268-7600

Interoperability endpoints

  • Direct secure messaging: lauren.le.1@31131.direct.athenahealth.com

Organizations & group practices 4

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1366637902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102003",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102003",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7648 N Paulina St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606261018",
            "country_code": "US",
            "telephone_number": "773-262-6622",
            "fax_number": "773-267-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "LAUREN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-024555",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019024555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.