Individual provider Active NPI

Lance A Kirby, PA-C

  • Physician Assistant
  • Lockport, IL
National Provider Identifier
1972552529
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085000829 Issued in IL
Practice address
16525 W 159TH St
Lockport, IL 60441-7900
Phone
(708) 720-0148
NPI assigned
May 10, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085000829 IL Primary

Addresses

Primary practice location

16525 W 159TH St
Lockport, IL 60441-7900

Mailing address

16525 W 159TH St
Lockport, IL 60441-7900
Phone (708) 720-0148

Other practice location 1

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7259

Other practice location 2

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7259

Other identifiers 1

IdentifierTypeStateIssuer
IL5686066OtherILMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkirby6267@Direct.FranciscanAlliance.org Direct

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085000829ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
P C Goodwin Medical LLC Past Accepting new patients
Midway Emergency Physicians, LLC Past Accepting new patients
Sterling Emergency Services of Indiana, Inc Physician Assistant Past Accepting new patients
Cottage Emergency Physicians LLC Past Accepting new patients
Three Rivers Emergency Physicians PLLC Past Accepting new patients
William B Evans MD SC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lkirby6267@direct.franciscanalliance.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1972552529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16525 W 159TH ST",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604417900",
            "telephone_number": "708-720-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16525 W 159TH ST",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604417900",
            "telephone_number": "708-720-0148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7531 S Stony Island Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606493954",
            "country_code": "US",
            "telephone_number": "773-947-7259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7531 S Stony Island Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606493954",
            "country_code": "US",
            "telephone_number": "773-947-7259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "LANCE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-09-29",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085000829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL5686066",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkirby6267@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3700 W 203rd St Ste 111",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.