Individual provider Active NPI

Sydney Marie Lafrenier, PA-C

  • Physician Assistant
  • Olympia Fields, IL
National Provider Identifier
1548083819
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.010922 Issued in IL
Practice address
3700 W 203Rd St Ste 301
Olympia Fields, IL 60461-1182
Phone
(708) 679-2850
Fax
(708) 503-3816
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.010922 IL Primary

Addresses

Primary practice location

3700 W 203Rd St Ste 301
Olympia Fields, IL 60461-1182

Mailing address

35318 Eagle Way
Chicago, IL 60678-1353
Phone (317) 528-4800

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
I20241205001102 IL Practitioner - Physician Assistant 7012443765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Specialty Physicians of Illinois LLCGroup PAC ID 4183529456, 114 clinicians

Practice addresses (Care Compare)

20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone (844) 740-4445

20201 S Crawford Ave
Suite 1400
Olympia Fields, IL 60461-1010
Phone (708) 379-2310

3700 W 203Rd St
Olympia Fields, IL 60461-1182

3800 W 203Rd St
Olympia Fields, IL 60461-1185

Hospital & facility affiliations

  • Franciscan Home Care Home health agency, Olympia Fields, IL, CCN 147267
  • Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172
  • Franciscan Health Dyer Hospital, Dyer, IN, CCN 150090
  • Franciscan Health Munster Hospital, Munster, IN, CCN 150165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.010922ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Illinois, LLC CurrentSince Dec 15, 2024 Accepting new patients
Specialty Physicians of Illinois, LLC Past Accepting new patients

Locations

35318 Eagle Way
Chicago, IL 60678

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

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.

Hospital & facility affiliations 4

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": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1548083819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35318 EAGLE WAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606781353",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 203RD ST STE 301",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611182",
            "telephone_number": "708-679-2850",
            "fax_number": "708-503-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFRENIER",
        "first_name": "SYDNEY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.