Individual provider Active NPI

Marshall David Lindheimer

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1972936581
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036043010 Issued in IL
Practice address
5807 S Dorchester Ave
5E
Chicago, IL 60637-1729
Phone
(773) 684-1049
Fax
(773) 702-5160
NPI assigned
Aug 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036043010 IL Primary

Addresses

Primary practice location

5807 S Dorchester Ave
5E
Chicago, IL 60637-1729

Mailing address

5807 S Dorchester Ave
5E
Chicago, IL 60637-1729
Phone (773) 684-1049

Other identifiers 1

IdentifierTypeStateIssuer
036043010OtherILSTATE OF ILLINOIS LICENSE (PHYSICIAN NAD SURGEON

Other names 1

  • Dr. Marshall David Lindheimer Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
036043010ILMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1972936581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5807 S DORCHESTER AVE",
            "address_2": "5E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371729",
            "telephone_number": "773-684-1049",
            "fax_number": "773-702-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5807 S DORCHESTER AVE",
            "address_2": "5E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371729",
            "telephone_number": "773-684-1049",
            "fax_number": "773-702-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDHEIMER",
        "first_name": "MARSHALL",
        "middle_name": "DAVID",
        "name_prefix": "Prof.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036043010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE (PHYSICIAN NAD SURGEON",
            "identifier": "036043010",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARSHALL",
            "last_name": "LINDHEIMER",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 19, 2013; 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.