Active NPI
Lawrence Alan Short, DPM
- Podiatrist
- Lake Bluff, IL
National Provider Identifier
1841306008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 016003095
- Practice address
- 71 Waukegan Road
Suite 200
Lake Bluff, IL 60044-1662 - Phone
- (847) 295-9301
- Fax
- (847) 295-9607
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 016003095 | IL | Primary |
Addresses
Primary practice location
71 Waukegan Road
Suite 200
Lake Bluff, IL 60044-1662
Mailing address
71 Waukegan Rd
Suite 200
Lake Bluff, IL 60044-3009
Phone (847) 295-9301
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60021233 | Other | IL | BCBS |
| 363267075 | Other | IL | HUMANA |
| 363267075 | Other | IL | UNICARE |
| 000102466006 | Other | IL | UNITED HEALTH CARE |
| 2502493 | Other | IL | CIGNA |
| 2137407 | Other | IL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016003095 | IL | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349049600000",
"number": "1841306008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 WAUKEGAN RD",
"address_2": "SUITE 200",
"city": "LAKE BLUFF",
"state": "IL",
"postal_code": "600443009",
"telephone_number": "847-295-9301",
"fax_number": "847-295-9607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 WAUKEGAN ROAD",
"address_2": "SUITE 200",
"city": "LAKE BLUFF",
"state": "IL",
"postal_code": "600441662",
"telephone_number": "847-295-9301",
"fax_number": "847-295-9607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "LAWRENCE",
"middle_name": "ALAN",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2012-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "016003095",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "60021233",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "363267075",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE",
"identifier": "363267075",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "000102466006",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2502493",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2137407",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Bluff, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.