Individual provider Active NPI

Georgia D Lubben, M. D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1619902236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone
(773) 947-7765
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

7531 S Stony Island Ave
Chicago, IL 60649-3954

Mailing address

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7765

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
I20110425000359 IL Practitioner - Family PracticePractitioner - Addiction Medicine 3072798735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
Chicago College of Medicine and Surgery, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friedell Clinic, S. C. 24 clinicians

Practice addresses (Care Compare)

1625 E 75TH St
FL 1
Chicago, IL 60649-3603

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7764

Hospital & facility affiliations

  • Jackson Park Hospital Hospital, Chicago, IL, CCN 140177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-064860ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Park Hospital Foundation Current Accepting new patients
Friedell Clinic, S. C. Family Medicine CurrentSince Jan 1, 1987 Accepting new patients

Locations

1625 E 75th St
Chicago, IL 60649
Phone (773) 947-2828

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

190 E Delaware Pl
Chicago, IL 60611
Phone (312) 944-0063

7531 S Stony Island Ave
#251
Chicago, IL 60649

Interoperability endpoints

  • Direct secure messaging: georgialubben@jph.medalliesdirect.net

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619902236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBBEN",
        "first_name": "GEORGIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.