Individual provider Active NPI

Lara Segalite, MD

  • Psychiatry Physician
  • Park Ridge, IL
National Provider Identifier
1700895257
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-093983 Issued in IL
Practice address
1875 W Dempster Suite 470
Park Ridge, IL 60068
Phone
(847) 795-3100
Fax
(847) 723-5882
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-093983 IL Primary

Addresses

Primary practice location

1875 W Dempster Suite 470
Park Ridge, IL 60068

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Other identifiers 1

IdentifierTypeStateIssuer
036093983MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address Lsegalite206471@direct.myadvocateaurora.org Direct

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
I20100106000716 IL Practitioner - PsychiatryPractitioner - Addiction Medicine 2769523216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

1775 Dempster St
Park Ridge, IL 60068-1143

1875 Dempster St
Park Ridge, IL 60068-1188

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

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-093983ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince May 1, 1999 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 1, 1999 Accepting new patients

Locations

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

29373 Network Pl
Chicago, IL 60673

1875 W Dempster St
Ste 470
Park Ridge, IL 60068
Phone (847) 795-3100

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.

Hospital & facility affiliations 1

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1700895257",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER SUITE 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-795-3100",
            "fax_number": "847-723-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGALITE",
        "first_name": "LARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-093983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093983",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1875 W Dempster Suite 470",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lsegalite206471@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 W Dempster Suite 470",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60068",
            "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.