Organization Active NPI

Lashawn D Freeman DPM SC

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1972692135
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016005098 Issued in IL
Legal business name
LASHAWN D FREEMAN DPM SC
Practice address
1525 E 53Rd St
Suite 816
Chicago, IL 60615-4557
Phone
(773) 363-5523
Fax
(773) 363-5602
NPI assigned
Oct 12, 2006
Last updated
Apr 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Authorized official

Name
Lashawn D Freeman, DPMNPI 1386685139
Title
Owner
Phone
(773) 363-5523

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016005098 IL Primary

Addresses

Primary practice location

1525 E 53Rd St
Suite 816
Chicago, IL 60615-4557

Mailing address

PO Box 19468
Chicago, IL 60619-0468
Phone (773) 363-5523

Other identifiers 2

IdentifierTypeStateIssuer
0001633214OtherILBLUE CROSS BLUE SHIELD
DD6800OtherILRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070424000625 IN Part B Supplier - Clinic/Group Practice 7214919653 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Portage, IN; Merrillville, IN; Gary, IN; Griffith, IN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1525 E 53rd St
Ste 816
Chicago, IL 60615
Phone (773) 363-5523

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1972692135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19468",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606190468",
            "telephone_number": "773-363-5523",
            "fax_number": "773-363-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST",
            "address_2": "SUITE 816",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154557",
            "telephone_number": "773-363-5523",
            "fax_number": "773-363-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASHAWN D FREEMAN DPM SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "LASHAWN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-363-5523",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001633214",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD6800",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.