Larry Wayne Desch, M.D.

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

036-093057 Issued in IL

Practice address

9555 S 52ND Ave
Oak Lawn, IL 60453-3054

Phone

(847) 318-9330

Fax

(708) 876-1561

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1912016783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 S 52ND AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533054",
            "telephone_number": "847-318-9330",
            "fax_number": "708-876-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 S 52ND AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533054",
            "telephone_number": "847-318-9330",
            "fax_number": "708-876-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESCH",
        "first_name": "LARRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036093057",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "IL",
            "license": "036093057",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "IL",
            "license": "036-093057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036093057",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0419824",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldesch207828@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTUR2/",
            "affiliation": "N",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Dennison
• Dermatology Center Associates SC
• William Derose, MD
• Janhavi Desai, PH.D.
• Stephanie Desalvo, ACNP-AG
• Julie Ann Devaney, MA,CCC-SLP
• Hillary Kieran Arlington Deveaux, MBBS
• Kristie Anne Devries, OTR/L
• Dewayne Drugs Inc.
• Benjamin Jacob Deyoung, DO, MPH

• Developmental - Behavioral Pediatrics Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Developmental - Behavioral Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.