Individual provider Active NPI

Katherine D Lynch, MD

  • Family Medicine Physician
  • Oak Park, IL
National Provider Identifier
1821038720
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036089584 Issued in IL
Practice address
1100 Lake St Ste 230
Oak Park, IL 60301-1095
Phone
(331) 221-9001
Fax
(331) 221-2759
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 036089584 IL Primary

Addresses

Primary practice location

1100 Lake St Ste 230
Oak Park, IL 60301-1095

Mailing address

4201 Winfield Rd FL 4
Centralized Services
Warrenville, IL 60555
Phone (331) 221-6377

Other identifiers 1

IdentifierTypeStateIssuer
036089584MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klynch208416@direct.edward.org Direct

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
I20040228000212 IL Practitioner - Family Practice 8325935091 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036089584ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Community Wellness Center CurrentSince Mar 24, 2016 Accepting new patients
PCC Community Wellness Center CurrentSince Mar 24, 2016 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Jun 8, 2020 Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Dec 11, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 11, 2023 Accepting new patients
Wyse Eyecare SC Past Accepting new patients
West Suburban Medical Center Family Medicine Past Accepting new patients
West Suburban Hospital Medical Center Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

5359 W Fullerton Ave
Chicago, IL 60639
Phone (773) 836-2785

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

1100 Lake St
Ste 230
Oak Park, IL 60301
Phone (331) 221-9244

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

4201 Winfield Rd
Fl 4
Warrenville, IL 60555

Interoperability endpoints

  • Direct secure messaging: klynch208416@direct.edward.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1821038720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD FL 4",
            "address_2": "CENTRALIZED SERVICES",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "60555",
            "telephone_number": "331-221-6377",
            "fax_number": "331-221-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE ST STE 230",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011095",
            "telephone_number": "331-221-9001",
            "fax_number": "331-221-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "KATHERINE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036089584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089584",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klynch208416@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1100 Lake St Ste 230",
            "city": "Oak Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "603011095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.