Lincoln Pediatric Center, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036085554 Issued in IL

Legal business name

LINCOLN PEDIATRIC CENTER, PC

Practice address

5641 N Lincoln Ave
Chicago, IL 60659-4921

Phone

(773) 728-4784

Fax

(773) 728-4759

NPI assigned

Mar 23, 2006

Last updated

Oct 26, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joann Eviota RuizNPI 1992765283

Title

Director

Phone

(773) 728-4784

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joann Eviota Ruiz, MD

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992765283
  NPD (past) Authorized official
• Jessica Bastidas, PA-C

  • Surgical Physician Assistant
  • Chicago, IL
  • NPI 1205238367
  NPD (past)
• Hayley Valene Belina, APRN

  • Nurse Practitioner
  • St Charles, IL
  • NPI 1750980876
  NPD (past)
• Sherr Ann Bianzon, FNP

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1407619927
  NPD (past)
• Anna Funsten

  • Pediatric Nurse Practitioner
  • Chicago, IL
  • NPI 1992215172
  NPD (past)
• Dina Levy Zimmerman, NP-C

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1699335018
  NPD (past)
• Megan Masters, APN

  • Pediatric Nurse Practitioner
  • Chicago, IL
  • NPI 1154964922
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1609836931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5641 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594921",
            "telephone_number": "773-728-4784",
            "fax_number": "773-728-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5641 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594921",
            "telephone_number": "773-728-4784",
            "fax_number": "773-728-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PEDIATRIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "JOANN",
        "authorized_official_middle_name": "EVIOTA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-728-4784",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036085554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085554",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lincoln Park Psychology, Inc.
• Lincoln Park Skilled Nursing Facility LLC (The Grove at Lincoln Park)
• Lincoln Park Supportive Living LLC
• Lincoln Park Terrace, Inc.
• Lincoln Park Therapy Group
• Lincoln Smiles Family Dentistry
• Lincoln Square Dental Associates, LTD.
• Lincoln Square Medical Associates, LTD.
• Lincoln Square Mindful Therapy
• Lincoln Square Optical

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.