Active NPI
Lynda Lane, MD
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1982699765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 2800 N Sheridan Rd
Suite 203
Chicago, IL 60657-6156 - Phone
- (773) 404-5263
- Fax
- (773) 404-1867
- NPI assigned
- Sep 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
2800 N Sheridan Rd
Suite 203
Chicago, IL 60657-6156
Mailing address
777 Oakmont LN
Suite 1600
Westmont, IL 60559-5511
Phone (630) 789-2550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0031604330 | Other | IL | BCBS PROVIDER ID |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100420000193 | IL | Practitioner - Family Practice | 8426185687 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-067827 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201478400000",
"number": "1982699765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 OAKMONT LN",
"address_2": "SUITE 1600",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605595511",
"telephone_number": "630-789-2550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 N SHERIDAN RD",
"address_2": "SUITE 203",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606576156",
"telephone_number": "773-404-5263",
"fax_number": "773-404-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "LYNDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2008-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "0031604330",
"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 Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.