LCR Primary Care LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

302F00000X Issued in IL

Legal business name

LCR PRIMARY CARE LLC

Practice address

9237 S.Pulaski
Ste. 2S
Evergreen Park, IL 60805

Phone

(773) 431-1508

NPI assigned

Nov 9, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Loretta B. Johnson, C.N.A.

Title

Owner

Phone

(773) 431-1508

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1588037873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9237 S PULASKI RD",
            "address_2": "STE 2S",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051454",
            "telephone_number": "773-431-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9237 S.PULASKI",
            "address_2": "STE. 2S",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "60805",
            "telephone_number": "773-431-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCR PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-431-1508",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C.N.A."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "302F00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lafaire
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• Naomi Marie Ledezma, MA
• Abby Lee, DMD, MS
• Erin Lee, LCSW
• Hae C. Lee, M.D.
• Jessica Genevieve Lee, MD

• Exclusive Provider Organization in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Exclusive Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.