Individual provider Active NPI

Lawrence Mark Krause, MD

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1578613527
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036-060787 Issued in IL
Practice address
111 N Wabash Ave Ste 1709
Chicago, IL 60602-2989
Phone
(847) 570-1700
Fax
(847) 926-5326
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036-060787 IL Primary

Addresses

Primary practice location

111 N Wabash Ave Ste 1709
Chicago, IL 60602-2989

Mailing address

351 Bluff St
Glencoe, IL 60022-2061
Phone (847) 570-1700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkrause11814@direct.northshore.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000656 IL Practitioner - General Surgery 7416908298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-060787ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Sep 1, 2014 Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 1, 2014 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

777 Park Ave W
Ste B400
Highland Park, IL 60035

757 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3800

Interoperability endpoints

  • Direct secure messaging: lkrause11814@direct.northshore.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1578613527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 BLUFF ST",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600222061",
            "telephone_number": "847-570-1700",
            "fax_number": "847-926-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE STE 1709",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022989",
            "telephone_number": "847-570-1700",
            "fax_number": "847-926-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "LAWRENCE",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-060787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkrause11814@direct.northshore.org",
            "affiliation": "N",
            "address_1": "777 Park Ave W Ste B400",
            "city": "Highland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600352433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.