Individual provider Active NPI

Kenneth Torres Lazaro, FNP-BC

  • Nurse Practitioner
  • Park Ridge, IL
National Provider Identifier
1649791195
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209016126 Issued in IL
Practice address
1775 Dempster St Ste E592C
Park Ridge, IL 60068-1143
Phone
(312) 609-0300
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209016126 IL
Nurse Practitioner 363L00000X 209016126 IL Primary

Addresses

Primary practice location

1775 Dempster St Ste E592C
Park Ridge, IL 60068-1143

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address klazaro205849@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170821001136 IL Practitioner - Nurse Practitioner 0143592576 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1775 Dempster St
Park Ridge, IL 60068-1143

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209016126ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Aug 1, 2022 Accepting new patients
Rush Oak Park ER Physicians Group CurrentSince Jul 31, 2017 Accepting new patients
Cep America - Illinois, LLP CurrentSince Nov 1, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 1, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Nov 1, 2021 Accepting new patients
Cepamerica Illinois LLP Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 30, 2018 Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Mar 30, 2018 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 16, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

233 S Gary Ave
Bloomingdale, IL 60108
Phone (630) 208-6775

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

75 Remittance Dr
Dept 1620
Chicago, IL 60675

29373 Network Pl
Chicago, IL 60673

2320 Royal Blvd
Ste C
Elgin, IL 60123
Phone (224) 783-5611

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

1775 Dempster St
Rm E592B
Park Ridge, IL 60068
Phone (847) 723-8080

1775 Dempster St
Ste E592C
Park Ridge, IL 60068

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: klazaro57086@direct.rush.rush-health.com
  • Direct secure messaging: klazaro205849@direct.myadvocateaurora.org

Organizations & group practices 9

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 3

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1649791195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST STE E592C",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "312-609-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARO",
        "first_name": "KENNETH",
        "middle_name": "TORRES",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016126",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209016126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klazaro205849@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St Ste E592C",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St Ste E592C",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.