Individual provider Active NPI

Lucas Andrew Walker, MD

  • Pediatric Critical Care Medicine Physician
  • Chicago, IL
National Provider Identifier
1780181529
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
036164381 Issued in IL
Practice address
5841 S Maryland Ave # L-444
Chicago, IL 60637-1443
Phone
(773) 834-3860
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD2000024 DC
Pediatric Critical Care Medicine Physician 2080P0203X 036164381 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # L-444
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (737) 702-1150

Other practice location 1

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (202) 476-5000

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
I20230927001404 IL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2769836501

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2000024DCMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1780181529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "737-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # L-444",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-3860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Michigan Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102916",
            "country_code": "US",
            "telephone_number": "202-476-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "LUCAS",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD2000024",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IL",
            "license": "036164381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.