Individual provider Active NPI

Lydia Ioanna Livas, MD

  • Child & Adolescent Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1629642087
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
036.170272 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-3407
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 036.170272 IL Primary
Psychiatry Physician 2084P0800X 2022-02843 NC
Psychiatry Physician 2084P0800X 036.170272 IL

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

225 E Chicago Ave # 2
Chicago, IL 60611-2991
Phone (312) 227-3407

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
I20250314001992 IL Practitioner - Psychiatry 3678973096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Kentucky College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mugen Psychiatry LLCGroup PAC ID 6002201613, 20 clinicians

Practice addresses (Care Compare)

3023 N Clark St
Suite 593
Chicago, IL 60657-5200
Phone (205) 427-9243

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.170272ILMDPsychiatry Physician
2022-02843NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mugen Psychiatry LLC Psychiatry CurrentSince Feb 1, 2025 Accepting new patients

Locations

3023 N Clark St
Ste 593
Chicago, IL 60657
Phone (205) 427-9243

3023 N Clark St
#593
Chicago, IL 60657
Phone (205) 427-9243

Organizations & group practices 1

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1629642087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVAS",
        "first_name": "LYDIA",
        "middle_name": "IOANNA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.170272",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2022-02843",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.170272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.