Individual provider Active NPI

J Keith Lemmon, M.D.

  • Allergy Physician
  • Glenview, IL
National Provider Identifier
1750499356
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
036106306 Issued in IL
Practice address
3633 W Lake Ave
Suite 412
Glenview, IL 60026-5805
Phone
(847) 657-6060
Fax
(847) 657-7070
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 036106306 IL Primary

Addresses

Primary practice location

3633 W Lake Ave
Suite 412
Glenview, IL 60026-5805

Mailing address

3633 W Lake Ave
Suite 412
Glenview, IL 60026-5805
Phone (847) 657-6060

Other identifiers 2

IdentifierTypeStateIssuer
036106306MedicaidIL
0001636306OtherILBLUE SHIELD BLUE CROSS

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
I20050829000535 IL Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 5799716874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3633 W Lake Ave
Suite 412
Glenview, IL 60026-5804
Phone (847) 657-6060

National Provider Directory

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

Organizations & group practices 1

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1750499356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 412",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-657-6060",
            "fax_number": "847-659-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 412",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-657-6060",
            "fax_number": "847-657-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMMON",
        "first_name": "J",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "036106306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036106306",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD BLUE CROSS",
            "identifier": "0001636306",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.