Individual provider Active NPI

Susan R Loring, MD

  • Family Medicine Physician
  • Crystal Lake, IL
National Provider Identifier
1487735528
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
101 N Virginia St
Ste 190
Crystal Lake, IL 60014-3426
Phone
(815) 444-1966
Fax
(815) 444-8699
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

101 N Virginia St
Ste 190
Crystal Lake, IL 60014-3426

Mailing address

101 N Virginia St
Ste 190
Crystal Lake, IL 60014-3426
Phone (815) 444-1966

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-092011ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487735528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N VIRGINIA ST",
            "address_2": "STE 190",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143426",
            "telephone_number": "815-444-1966",
            "fax_number": "815-444-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N VIRGINIA ST",
            "address_2": "STE 190",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143426",
            "telephone_number": "815-444-1966",
            "fax_number": "815-444-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORING",
        "first_name": "SUSAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.