Individual provider Active NPI

Lawrence Hollander, MD, FACS

  • Surgery Physician
  • Mount Vernon, IL
National Provider Identifier
1912959578
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
209 Crossroads PL
Suite #130
Mount Vernon, IL 62864-6254
Phone
(618) 242-3831
Fax
(618) 242-3375
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X IL Primary

Addresses

Primary practice location

209 Crossroads PL
Suite #130
Mount Vernon, IL 62864-6254

Mailing address

209 Crossroads PL
Suite #130
Mount Vernon, IL 62864-6254
Phone (618) 242-3831

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-043310ILMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: lhollander@yourcarecommunity.org

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1912959578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 CROSSROADS PL",
            "address_2": "SUITE #130",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646254",
            "telephone_number": "618-242-3831",
            "fax_number": "618-242-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CROSSROADS PL",
            "address_2": "SUITE #130",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646254",
            "telephone_number": "618-242-3831",
            "fax_number": "618-242-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDER",
        "first_name": "LAWRENCE",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.