Active NPI
Lacy A Knight, MD
- Emergency Medical Services (Emergency Medicine) Physician
- Lake Forest, IL
National Provider Identifier
1487630448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- 36107997
- Practice address
- 660 N Westmoreland Rd
Lake Forest, IL 60045-1659 - Phone
- (847) 535-6150
- Fax
- (847) 535-7801
- NPI assigned
- Dec 21, 2005
- Last updated
- Mar 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 36107997 | IL | Primary |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 036107997 | IL |
Addresses
Primary practice location
660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Mailing address
660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 535-6150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36107997 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036107997 | IL | MD | Emergency Medical Services (Emergency Medicine) Physician |
| 36107997 | IL | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Oncology-Hematology Associates, LTD. | Past | Accepting new patients | |
| Advocate Health and Hospitals Corporation | 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.
-
dba Advocate Children's Hospital
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Hematology & Oncology Physician
- Libertyville, IL
- NPI 1023090925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394582400000",
"number": "1487630448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 N WESTMORELAND RD",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600451659",
"telephone_number": "847-535-6150",
"fax_number": "847-535-7801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 N WESTMORELAND RD",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600451659",
"telephone_number": "847-535-6150",
"fax_number": "847-535-7801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNIGHT",
"first_name": "LACY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-21",
"last_updated": "2014-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "IL",
"license": "36107997",
"primary": true
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "IL",
"license": "036107997",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36107997",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lake Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.