Individual provider Active NPI

Lei Yan, M.D., PH.D

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1487068078
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
125-065139 Issued in IL
Practice address
1653 W Congress Pkwy
Jelke Building, Department of Pathology
Chicago, IL 60612-3833
Phone
(504) 617-2165
NPI assigned
Jun 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 125-065139 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Jelke Building, Department of Pathology
Chicago, IL 60612-3833

Mailing address

7645 Gladstone Dr
#202
Naperville, IL 60565-1120
Phone (504) 617-2165

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
I20200415002564 IL Practitioner - Pathology 6002106721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
University Pathology Diagnostics SCGroup PAC ID 1052692464, 17 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-5000

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063
  • Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036142949ILMDNeurological Surgery Physician
125-065139ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pathology Diagnostics SC Anatomic Pathology & Clinical Pathology CurrentSince Mar 7, 2020 Accepting new patients
University Pathologists P C Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

1653 W Congress Pkwy
Ste 570
Chicago, IL 60612

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

5700 Southwyck Blvd
Toledo, OH 43614

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1487068078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7645 GLADSTONE DR",
            "address_2": "#202",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651120",
            "telephone_number": "504-617-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "JELKE BUILDING, DEPARTMENT OF PATHOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "504-617-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "LEI",
        "credential": "M.D., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125-065139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.