Heather Marie Lacey

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010428 Issued in IL

Practice address

4711 Golf Rd Ste 1100
Skokie, IL 60076-1249

Phone

(847) 933-9339

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Clinical

  Medicare reassignment NPD
• Rush University Medical Center

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1689165540
  NPD

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1619438058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 US HIGHWAY 45 N",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629303766",
            "telephone_number": "708-288-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 1100",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761249",
            "telephone_number": "847-933-9339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1412 US Highway 45 N",
            "address_purpose": "LOCATION",
            "city": "Eldorado",
            "state": "IL",
            "postal_code": "629303766",
            "country_code": "US",
            "telephone_number": "708-288-5936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Kwan, O.D.
• Edwin Dewees Kyle III, PAC
• Frank Paul La Franco, MD
• Jamie La, APN
• Wilson Flanco Labidez, PT
• Carol Laderman, M.D.
• Laura Lafave, MD
• Lake Shore Gastroenterology
• Lake Shore Gastroenterology
• Lakeside Nephrology, LTD.

• Clinical Psychologist in Skokie, IL
• Providers in Skokie, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.