Individual provider Active NPI

Laura M Mikhail, M.D.

  • Pediatric Adolescent Medicine Physician
  • Chicago, IL
National Provider Identifier
1528067857
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
036108530 Issued in IL
Practice address
1030 N Clark St
Suite 400
Chicago, IL 60610-5467
Phone
(312) 943-6964
Fax
(312) 943-6924
NPI assigned
Jul 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 036108530 IL Primary

Addresses

Primary practice location

1030 N Clark St
Suite 400
Chicago, IL 60610-5467

Mailing address

PO Box 189
Matteson, IL 60443-0189
Phone (708) 747-5850

Other identifiers 1

IdentifierTypeStateIssuer
036108530MedicaidIL

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
036108530ILMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children'S Hospital of Chicago Current Accepting new patients
Child & Adolescent Health Assoc LTD Past Accepting new patients
Illinois Oculoplastic Associates SC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lmikhail14207@direct.luriechildrens.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1528067857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430189",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N CLARK ST",
            "address_2": "SUITE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606105467",
            "telephone_number": "312-943-6964",
            "fax_number": "312-943-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAIL",
        "first_name": "LAURA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036108530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.