Active NPI
Virginia Lennon, PA-C
- Physician Assistant
- Chicago, IL
National Provider Identifier
1568136141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.008682
- Practice address
- 10701 S Ewing Ave
Chicago, IL 60617-6606 - Phone
- (773) 731-9000
- NPI assigned
- Aug 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 085.008682 | IL | Primary |
Addresses
Primary practice location
10701 S Ewing Ave
Chicago, IL 60617-6606
Mailing address
627 Tom Kemp Dr
New Braunfels, TX 78130-3681
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.008682 | IL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1568136141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "627 TOM KEMP DR",
"city": "NEW BRAUNFELS",
"state": "TX",
"postal_code": "781303681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10701 S EWING AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606176606",
"telephone_number": "773-731-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LENNON",
"first_name": "VIRGINIA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-05",
"last_updated": "2021-12-08",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.008682",
"primary": true
}
],
"identifiers": [],
"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 Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.