Individual provider Active NPI

Barbara Dawn Loris, M.D.

  • Surgery Physician
  • Highland Park, IL
National Provider Identifier
1649252602
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036097452 Issued in IL
Practice address
767 Park Ave W
Suite 320
Highland Park, IL 60035-2400
Phone
(847) 433-1060
Fax
(847) 433-1399
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036097452 IL Primary

Addresses

Primary practice location

767 Park Ave W
Suite 320
Highland Park, IL 60035-2400

Mailing address

767 Park Ave W
Suite 320
Highland Park, IL 60035-2400
Phone (847) 433-1060

Other identifiers 1

IdentifierTypeStateIssuer
036097452MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036097452ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in General Surgery, S.C. Surgery Past Accepting new patients

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1649252602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 PARK AVE W",
            "address_2": "SUITE 320",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352400",
            "telephone_number": "847-433-1060",
            "fax_number": "847-433-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 PARK AVE W",
            "address_2": "SUITE 320",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352400",
            "telephone_number": "847-433-1060",
            "fax_number": "847-433-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORIS",
        "first_name": "BARBARA",
        "middle_name": "DAWN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036097452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097452",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.