NPIMap

Individual provider Active NPI

Lynda Roden, DOSC

  • Internal Medicine Physician
  • Libertyville, IL
National Provider Identifier
1689790008
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-098545 Issued in IL
Practice address
1870 W Winchester Rd
Ste 143
Libertyville, IL 60048-5358
Phone
(847) 549-7777
Fax
(847) 549-7779
NPI assigned
Mar 21, 2007
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-098545 IL Primary

Addresses

Primary practice location

1870 W Winchester Rd
Ste 143
Libertyville, IL 60048-5358

Mailing address

1870 W Winchester Rd
Ste 143
Libertyville, IL 60048-5358
Phone (847) 549-7777

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lroden206612@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080917000049 IL Practitioner - Internal Medicine 3971571282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1445 N Hunt Club Rd
Gurnee, IL 60031-2603

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036-098545ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Sep 29, 2014 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Sep 29, 2014 Accepting new patients

Locations

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

29373 Network Pl
Chicago, IL 60673

Interoperability endpoints

  • Direct secure messaging: lroden206612@direct.myadvocateaurora.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1689790008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD",
            "address_2": "STE 143",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485358",
            "telephone_number": "847-549-7777",
            "fax_number": "847-549-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD",
            "address_2": "STE 143",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485358",
            "telephone_number": "847-549-7777",
            "fax_number": "847-549-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN",
        "first_name": "LYNDA",
        "credential": "DOSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-098545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lroden206612@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1870 W Winchester Rd",
            "address_2": "Ste 143",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485358",
            "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": "1870 W Winchester Rd",
            "address_2": "Ste 143",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.