Individual provider Active NPI

Danielle Marie Leachman, PA-C

  • Medical Physician Assistant
  • Skokie, IL
National Provider Identifier
1811529464
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.008450 Issued in IL
Practice address
4709 Golf Rd Ste 300
Skokie, IL 60076-1233
Phone
(847) 869-7233
Fax
(847) 869-9461
NPI assigned
Feb 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 085.008450 IL Primary

Addresses

Primary practice location

4709 Golf Rd Ste 300
Skokie, IL 60076-1233

Mailing address

4709 Golf Rd Ste 300
Skokie, IL 60076-1233
Phone (847) 869-7233

Other names 1

  • Danielle Marie Lacour Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220506001417 IL Practitioner - Physician Assistant 4183001423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Northwestern University Feinberg Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics and Rheumatology of the North Shore SCGroup PAC ID 4981707494, 7 clinicians

Practice addresses (Care Compare)

4709 Golf Rd
Suite 300
Skokie, IL 60076-1233
Phone (847) 869-7233

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

Merit-based Incentive Payment System (MIPS)

Final score
93.61 of 100Reported as group
Quality
87.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008450ILMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: dlacour@orns.ssdirect.aprima.com

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.

Hospital & facility affiliations 1

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": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1811529464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761233",
            "telephone_number": "847-869-7233",
            "fax_number": "847-869-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761233",
            "telephone_number": "847-869-7233",
            "fax_number": "847-869-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACHMAN",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2024-03-15",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.008450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "LACOUR",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.