Individual provider Active NPI

Karole A Lakota Treese, MD

  • Family Medicine Physician
  • Oak Park, IL
National Provider Identifier
1952365488
Registry record updated Dec 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036103349 Issued in IL
Practice address
14 W Lake St
Oak Park, IL 60302-2606
Phone
(708) 383-0113
Fax
(708) 383-9911
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036103349 IL Primary

Addresses

Primary practice location

14 W Lake St
Oak Park, IL 60302-2606

Mailing address

14 W Lake St
Oak Park, IL 60302-2606
Phone (708) 383-0113

Other identifiers 1

IdentifierTypeStateIssuer
036103349MedicaidIL

Other names 1

  • Karole A Lakota Former name

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
I20050520000660 IL Practitioner - Family Practice 8729029616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians

Practice addresses (Care Compare)

14 Lake St
Oak Park, IL 60302-2606
Phone 7083830113220005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036103349ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Community Wellness Center CurrentSince Jan 1, 2004 Accepting new patients
PCC Community Wellness Center CurrentSince Jan 1, 2004 Accepting new patients
West Suburban Hospital Medical Center Past Accepting new patients
West Suburban Medical Center Family Medicine Past Accepting new patients
PCC Community Wellness Center Past Accepting new patients

Locations

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

Interoperability endpoints

  • Direct secure messaging: karole.lakota.1@13158.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1952365488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606",
            "telephone_number": "708-383-0113",
            "fax_number": "708-383-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 W LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606",
            "telephone_number": "708-383-0113",
            "fax_number": "708-383-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKOTA TREESE",
        "first_name": "KAROLE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103349",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAROLE",
            "last_name": "LAKOTA",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.