Individual provider Active NPI

Leslie Smebak, MD

  • Family Medicine Physician
  • Oak Park, IL
National Provider Identifier
1760973515
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.157901 Issued in IL
Practice address
14 Lake St
Oak Park, IL 60302-2606
NPI assigned
May 28, 2018
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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 036.157901 IL Primary

Addresses

Primary practice location

14 Lake St
Oak Park, IL 60302-2606

Mailing address

14 Lake St
Oak Park, IL 60302-2606
Phone (708) 383-0113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211109002289 IL Practitioner - Family Practice 7012306202 Reassigns benefits to 1 organization
I20240801001027 MN Practitioner - Family Practice 7012306202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

4209 Webber Pkwy
Minneapolis, MN 55412-1747
Phone (763) 581-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.157901ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care Current Accepting new patients
North Memorial Health Care CurrentSince Aug 1, 2024 Accepting new patients
North Memorial Health Care CurrentSince Aug 1, 2024 Accepting new patients
PCC Community Wellness Center CurrentSince Aug 9, 2021 Accepting new patients
PCC Community Wellness Center CurrentSince Aug 9, 2021 Accepting new patients
Maple Grove Hospital Corporation Past Accepting new patients

Locations

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

4209 Webber Pkwy
Minneapolis, MN 55412
Phone (763) 553-0544

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Interoperability endpoints

  • Direct secure messaging: lsmebak208247@direct.northmemorial.com

Organizations & group practices 6

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 4

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": "1527465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1760973515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606",
            "telephone_number": "708-383-0113",
            "fax_number": "708-383-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMEBAK",
        "first_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-28",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.157901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.