Individual provider Active NPI

Concepta Lasquite, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1700922648
Registry record updated May 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036083208 Issued in IL
Practice address
1817 S Loomis St
Chicago, IL 60608-3018
Phone
(312) 666-6511
Fax
(312) 666-1658
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036083208 IL Primary

Addresses

Primary practice location

1817 S Loomis St
Chicago, IL 60608-3018

Mailing address

1817 S Loomis St
Chicago, IL 60608-3018
Phone (312) 666-6511

Other identifiers 1

IdentifierTypeStateIssuer
0360832081MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network Current Accepting new patients
Access Community Health Network CurrentSince Jun 1, 2010 Accepting new patients
Access Community Health Network CurrentSince Jun 1, 2010 Accepting new patients

Locations

1817 S Loomis St
Chicago, IL 60608
Phone (312) 666-6511

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

Organizations & group practices 3

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336867200000",
    "number": "1700922648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 S LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083018",
            "telephone_number": "312-666-6511",
            "fax_number": "312-666-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 S LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083018",
            "telephone_number": "312-666-6511",
            "fax_number": "312-666-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASQUITE",
        "first_name": "CONCEPTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036083208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360832081",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.