Individual provider Active NPI

Lawrence A Lindeman, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1386643864
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-069122 Issued in IL
Practice address
2255 W Roscoe St
Chicago, IL 60618-6238
Phone
(773) 832-1081
Fax
(773) 832-1082
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-069122 IL Primary

Addresses

Primary practice location

2255 W Roscoe St
Chicago, IL 60618-6238

Mailing address

PO Box 872
Evanston, IL 60204-0872
Phone (773) 832-1081

Other identifiers 1

IdentifierTypeStateIssuer
036069122MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207000588 IL Practitioner - Family Practice 5294791729

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-069122ILMDFamily Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIAJBA/Endpoint/BIAJBA

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1386643864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 872",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602040872",
            "telephone_number": "773-832-1081",
            "fax_number": "773-832-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186238",
            "telephone_number": "773-832-1081",
            "fax_number": "773-832-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDEMAN",
        "first_name": "LAWRENCE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-069122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069122",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.