Alex Lickerman, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036090525 Issued in IL

Practice address

10 S Riverside PLZ Ste 2225
Chicago, IL 60606

Phone

(312) 374-5862

Fax

(312) 628-5100

NPI assigned

May 23, 2007

Last updated

Aug 20, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Imaginemd

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1437638574
  Authorized official Same address or phone

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1891905998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S RIVERSIDE PLZ STE 2225",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063707",
            "telephone_number": "312-374-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S RIVERSIDE PLZ STE 2225",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60606",
            "telephone_number": "312-374-5862",
            "fax_number": "312-628-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKERMAN",
        "first_name": "ALEX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036090525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090525",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Sara Lichtenstein, M.D.
• Katharine Lichter
• Lauren Lichterman, PT, DPT
• Marla Lichterman, LCSW
• Asher Eli Lichtig, MD
• Lauren Lickert, PMHNP-BC
• Licudine & Licudine MD SC
• Nicholas Licudine, PT
• Normita Madamba Licudine, MD
• Thomas Jackson Lidahl

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.