Individual provider Active NPI

Mary E Lynn, DO

  • Gynecology Physician
  • Maywood, IL
National Provider Identifier
1841379690
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
036111813 Issued in IL
Practice address
2160 S 1St Ave
BLDG. 103, Room 1019
Maywood, IL 60153-3328
Phone
(708) 216-3380
Fax
(708) 216-6148
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 036111813 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
BLDG. 103, Room 1019
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
BLDG. 103, Room 1019
Maywood, IL 60153-3328
Phone (708) 216-3380

Other identifiers 1

IdentifierTypeStateIssuer
43521100MedicaidWI

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
I20080915000472 IL Practitioner - Obstetrics/Gynecology 7113953753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Aug 1, 2008 Accepting new patients
Loyola University Medical Center CurrentSince Aug 1, 2008 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

300 N York St
Elmhurst, IL 60126
Phone (708) 327-7030

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Bldg 103
Maywood, IL 60153
Phone (708) 216-6462

2160 S 1st Ave
Bldg 108
Maywood, IL 60153
Phone (708) 216-6200

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Interoperability endpoints

  • Direct secure messaging: mlynn34073@direct.luhs.org

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.

Hospital & facility affiliations 3

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1841379690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "BLDG. 103, ROOM 1019",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3380",
            "fax_number": "708-216-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "BLDG. 103, ROOM 1019",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3380",
            "fax_number": "708-216-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036111813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43521100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.