Individual provider Active NPI

Lauren Ball, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1629776646
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085010428 Issued in IL
Practice address
1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Phone
(877) 632-6637
Fax
(708) 409-5179
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004377A IN
Physician Assistant 363A00000X 085010428 IL Primary

Addresses

Primary practice location

1611 W Harrison St Ste 400
Chicago, IL 60612-4861

Mailing address

PO Box 735263
Chicago, IL 60673-5263
Phone (877) 632-6637

Other practice location 1

9200 Calumet Ave Ste 300
Munster, IN 46321-2885
Phone (877) 632-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240423003112 IL Practitioner - Physician Assistant 4587003512 Reassigns benefits to 1 organization
I20240521001016 IN Practitioner - Physician Assistant 4587003512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10004377AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Physician Assistant CurrentSince Mar 29, 2024 Accepting new patients
Orthomidwest, PLLC CurrentSince Mar 29, 2024 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

9200 Calumet Ave
Ste 300
Munster, IN 46321
Phone (708) 236-2737

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

Interoperability endpoints

  • Direct secure messaging: lauren.ball.1@12576.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1629776646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 Calumet Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212885",
            "country_code": "US",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALL",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004377A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.