Individual provider Active NPI

Roger A. Lichtenbaum, M.D.

  • Neurological Surgery Physician
  • Chicago, IL
National Provider Identifier
1760569933
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036.120110 Issued in IL
Practice address
836 W Wellington Ave
Chicago, IL 60657-5147
Phone
(773) 975-1600
NPI assigned
Nov 1, 2006
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036.120110 IL Primary
Neurological Surgery Physician 207T00000X 237178 NY

Addresses

Primary practice location

836 W Wellington Ave
Chicago, IL 60657-5147

Mailing address

29373 Network PL
Chicago, IL 60673-0001
Phone (847) 390-5900

Other practice location 1

1801 W. Taylor Street
4E
Chicago, IL 60612
Phone (312) 355-4300

Other practice location 2

1431 N Western Ave Ste 306
Chicago, IL 60622-1775
Phone (312) 332-2226

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rlichtenbaum5291@ce-direct.presencehealth.org
Direct Messaging Address rlichtenbaum380792@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: 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
I20081030000552 IL Practitioner - Neurosurgery 7618036070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
New York University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

836 W Wellington
Suite G346
Chicago, IL 60657-5147
Phone (773) 296-7147

836 W Wellington Ave
Chicago, IL 60657-5147

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion51
Laminectomy or laminotomy (partial removal of spine bones)25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.120110ILMDNeurological Surgery Physician
237178NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jul 1, 2008 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 1, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Neurological Surgery CurrentSince Jul 1, 2008 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Aug 1, 2023 Accepting new patients
Presence Central and Suburban Hospitals Network Neurological Surgery PastSince Jun 1, 2015 Accepting new patients
Mercy Medical Center - Aurora LLC Past Accepting new patients

Locations

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

1431 N Western Ave
Ste 306
Chicago, IL 60622
Phone (312) 332-2226

1801 W Taylor St
#4E
Chicago, IL 60612
Phone (312) 355-4300

29373 Network Pl
Chicago, IL 60673

3000 N Halsted St
Ste 625
Chicago, IL 60657
Phone (773) 296-3450

7447 W Talcott Ave
Ste 233
Chicago, IL 60631
Phone (815) 725-4367

75 Remittance Dr
Dept 1577
Chicago, IL 60675
Phone (815) 725-4367

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

836 W Wellington Ave
Chicago, IL 60657
Phone (773) 296-7054

912 S Wood St
Fl 4
Chicago, IL 60612

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

Interoperability endpoints

  • Direct secure messaging: rlichtenbaum380792@direct.myadvocateaurora.org
  • Direct secure messaging: rlichtenbaum5291@ce-direct.presencehealth.org

Organizations & group practices 8

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 2

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1760569933",
    "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": "606730001",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-975-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W. Taylor Street",
            "address_2": "4E",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60612",
            "country_code": "US",
            "telephone_number": "312-355-4300",
            "fax_number": "312-996-9018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1431 N Western Ave Ste 306",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221775",
            "country_code": "US",
            "telephone_number": "312-332-2226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTENBAUM",
        "first_name": "ROGER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036.120110",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "237178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlichtenbaum5291@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "1431 N Western Ave Ste 306",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606221775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlichtenbaum380792@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "836 W Wellington Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575147",
            "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": "836 W Wellington Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.