Active NPI
Lauren Marie Kofod, MD
- Psychiatry Physician
- Lemont, IL
National Provider Identifier
1912063686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036127764
- Practice address
- 40 Timberline Dr
Lemont, IL 60439-3848 - Phone
- (630) 248-6635
- NPI assigned
- Dec 28, 2006
- Last updated
- May 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036127764 | IL | Primary |
| Psychiatry Physician | 2084P0800X | MD429623 | PA |
Addresses
Primary practice location
40 Timberline Dr
Lemont, IL 60439-3848
Mailing address
40 Timberline Dr
Lemont, IL 60439-3848
Phone (630) 248-6635
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Apr 17, 2026 through Apr 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036127764 | IL | MD | Psychiatry Physician |
| MD429623 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306454400000",
"number": "1912063686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 TIMBERLINE DR",
"city": "LEMONT",
"state": "IL",
"postal_code": "604393848",
"telephone_number": "630-248-6635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 TIMBERLINE DR",
"city": "LEMONT",
"state": "IL",
"postal_code": "604393848",
"telephone_number": "630-248-6635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOFOD",
"first_name": "LAUREN",
"middle_name": "MARIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2011-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036127764",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD429623",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lemont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.