Individual provider Active NPI

Dustin Lamb, CRNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1538989942
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.030763 Issued in IL
Practice address
1520 N Damen Ave
Chicago, IL 60622-1967
Phone
(312) 283-5560
NPI assigned
Oct 11, 2024
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.030763 IL Primary

Addresses

Primary practice location

1520 N Damen Ave
Chicago, IL 60622-1967

Mailing address

210 N Wells St Apt 2108
Chicago, IL 60606-1341
Phone (256) 777-7800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030000782 IL Practitioner - Nurse Practitioner 2163955196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.030763ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Oct 14, 2024 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Oct 14, 2024 Accepting new patients

Locations

1520 N Damen Ave
Chicago, IL 60622
Phone (312) 278-5955

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

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.

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1538989942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N WELLS ST APT 2108",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061341",
            "telephone_number": "256-777-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221967",
            "telephone_number": "312-283-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMB",
        "first_name": "DUSTIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.030763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.