Individual provider Active NPI

Lauren Ann Fine, MD

  • Dermatology Physician
  • Chicago, IL
National Provider Identifier
1790923241
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036.125993 Issued in IL
Practice address
3000 N Halsted St Ste 701
Chicago, IL 60657-5196
Phone
(773) 572-5796
Fax
(773) 572-5024
NPI assigned
Jan 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036.125993 IL Primary

Addresses

Primary practice location

3000 N Halsted St Ste 701
Chicago, IL 60657-5196

Mailing address

500 W Superior St Unit 1012
Chicago, IL 60654-8137
Phone (847) 275-3479

Other identifiers 1

IdentifierTypeStateIssuer
036-125993MedicaidIL

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
I20110418000653 IL Practitioner - Dermatology 8527242478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rush Medical College of Rush University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3000 N Halsted St
Chicago, IL 60657-5196
Phone (773) 572-5796

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions40
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.125993ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fine Dermatology LLC Dermatology CurrentSince Nov 15, 2023 Accepting new patients
Physicians Dermpath Laboratory Past Accepting new patients
Derick Dermatology, PLLC Dermatology Past Accepting new patients

Locations

3000 N Halsted St
Ste 701
Chicago, IL 60657
Phone (773) 296-3888

Organizations & group practices 3

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": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1790923241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W SUPERIOR ST UNIT 1012",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606548137",
            "telephone_number": "847-275-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 701",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "773-572-5796",
            "fax_number": "773-572-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "LAUREN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.125993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-125993",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.