Individual provider Active NPI

Lawrence Marczak, DPM

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1831129170
Registry record updated Oct 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016003003 Issued in IL
Practice address
30 N Michigan Ave
Suite 1229
Chicago, IL 60602-3402
Phone
(312) 332-0041
Fax
(312) 332-2324
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016003003 IL Primary

Addresses

Primary practice location

30 N Michigan Ave
Suite 1229
Chicago, IL 60602-3402

Mailing address

30 N Michigan Ave
Suite 1229
Chicago, IL 60602-3402
Phone (312) 332-0041

Other identifiers 1

IdentifierTypeStateIssuer
016003003MedicaidIL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101208001251 IL Practitioner - Podiatry 5496880189 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5511 /2 W Montrose
Chicago, IL 60641-1331

5511 /2 W Montrose Ave
Chicago, IL 60641-1331
Phone (773) 283-6200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue22
Removal of nail tissue66
Removal or shaving of skin growth47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Care Consultants Podiatrist CurrentSince Nov 19, 2017 Accepting new patients
Dr Lawrence Marczak LTD Podiatrist CurrentSince Jul 1, 1979 Accepting new patients
Podiatric Management Systems LLC Past Accepting new patients

Locations

5511 W Montrose Ave
Chicago, IL 60641
Phone (773) 283-6200

30 N Michigan Ave
Ste 1229
Chicago, IL 60602
Phone (312) 332-0041

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1831129170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1229",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-332-0041",
            "fax_number": "312-332-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1229",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-332-0041",
            "fax_number": "312-332-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCZAK",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003003",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.