Individual provider Active NPI

Namyr Hernandez Lartigue

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1376272963
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.010563 Issued in IL
Practice address
3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone
(773) 782-2800
NPI assigned
Jun 8, 2022
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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 085.010563 IL Primary

Addresses

Primary practice location

3600 W Fullerton Ave
Chicago, IL 60647-2319

Mailing address

3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone (773) 782-2800

Other practice location 1

6416 W Belmont Ave
Chicago, IL 60634-3921
Phone (773) 782-2800

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
I20241008003141 IL Practitioner - Physician Assistant 8325579899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infant Welfare Society of ChicagoGroup PAC ID 6800137407, 6 clinicians

Practice addresses (Care Compare)

3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone (773) 782-2800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.010563ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infant Welfare Society of Chicago Past Accepting new patients

Organizations & group practices 2

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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1376272963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6416 W Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606343921",
            "country_code": "US",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ LARTIGUE",
        "first_name": "NAMYR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.