Individual provider Active NPI

Rick Lara

  • Public Health & General Preventive Medicine Physician
  • Chicago, IL
National Provider Identifier
1740590652
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
001151 Issued in IL
Practice address
2133 W Lexington St
2ND Floor
Chicago, IL 60612-3707
Phone
(312) 746-7832
Fax
(312) 746-6526
NPI assigned
Oct 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 001151 IL Primary

Addresses

Primary practice location

2133 W Lexington St
2ND Floor
Chicago, IL 60612-3707

Mailing address

2133 W Lexington St
2ND Floor
Chicago, IL 60612-3707
Phone (312) 746-7832

Other identifiers 1

IdentifierTypeStateIssuer
001151OtherILRISK ASSESSOR

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001151ILMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1740590652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 W LEXINGTON ST",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123707",
            "telephone_number": "312-746-7832",
            "fax_number": "312-746-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 W LEXINGTON ST",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123707",
            "telephone_number": "312-746-7832",
            "fax_number": "312-746-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "RICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "IL",
            "license": "001151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RISK ASSESSOR",
            "identifier": "001151",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.