Individual provider Active NPI

Edythe Lotharius, M.D.

  • Emergency Medicine Physician
  • Buffalo Grove, IL
National Provider Identifier
1477578896
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-108404 Issued in IL
Practice address
150 W Half Day Rd
Buffalo Grove, IL 60089-6591
Phone
(847) 215-0000
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01040494A IN
Emergency Medicine Physician 207P00000X 036-108404 IL Primary

Addresses

Primary practice location

150 W Half Day Rd
Buffalo Grove, IL 60089-6591

Mailing address

75 Remit Drive
Lockbox 1218
Chicago, IL 60675-1218
Phone (866) 916-5259

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elotharius236535@direct.myadvocateaurora.org Direct

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
I20051122000076 IL Practitioner - Internal Medicine 6709805534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake County Acute Care LLPGroup PAC ID 5395747281, 17 clinicians

Practice addresses (Care Compare)

1445 Hunt Club Rd
Suite 101
Gurnee, IL 60031-5257
Phone (847) 249-2800

150 W Half Day Rd
Buffalo Grove, IL 60089-6591
Phone (847) 215-0000

2 E Rollins Rd
Round Lake Beach, IL 60073-3808
Phone (847) 740-2500

6 E Phillip Rd
Vernon Hills, IL 60061-1700
Phone (847) 680-0500

6440 Grand Ave
Gurnee, IL 60031-5257
Phone (847) 855-0550

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-108404ILMDEmergency Medicine Physician
01040494AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Acute Care, LLP Current Accepting new patients
Lake County Acute Care, LLP CurrentSince Feb 1, 2007 Accepting new patients
Lake County Acute Care, LLP CurrentSince Feb 1, 2007 Accepting new patients
Midwest Palliative & Hospice Carecenter Past Accepting new patients

Locations

150 W Half Day Rd
Buffalo Grove, IL 60089
Phone (847) 215-0000

75 Remit Dr
Chicago, IL 60675

6 E Phillip Rd
Ste 1102
Vernon Hills, IL 60061
Phone (847) 680-0500

6 E Phillip Rd
Vernon Hills, IL 60061
Phone (847) 362-5353

200 Corporate Blvd
Lafayette, LA 70508

Interoperability endpoints

  • Direct secure messaging: elotharius236535@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1477578896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DRIVE",
            "address_2": "LOCKBOX 1218",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751218",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W HALF DAY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896591",
            "telephone_number": "847-215-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTHARIUS",
        "first_name": "EDYTHE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01040494A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-108404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elotharius236535@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 W Half Day Rd",
            "city": "Buffalo Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600896591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.