DR. ABRAHAN LARA-PACHECO MD - NPI 1639799109 - General Practice in Chicago, IL

Q: What is Abrahan Lara-pacheco's NPI number?

The NPI number for Abrahan Lara-pacheco is 1639799109. It was assigned to this individual provider in the NPPES registry on April 24, 2020.

Q: What is Abrahan Lara-pacheco's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

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About Dr. Abrahan Lara-pacheco Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ABRAHAN LARA-PACHECO MD (NPI 1639799109) is an individual general practice provider in Chicago, Illinois, licensed in Illinois (036.164104) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Burr Ridge, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1639799109

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. ABRAHAN LARA-PACHECOCredential: MD

Location Address5841 S MARYLAND AVE STE MC6098Chicago, IL 60637-1448

Mailing Address180 Harvester Dr Ste 110Burr Ridge, IL 60527-6686 · (773) 702-1150

Phone(855) 702-8222

Fax(773) 753-0552

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateApril 24, 2020

Last NPPES UpdateOctober 15, 20244 updates tracked since enumeration

NPPES CertifiedJuly 3, 2023

✔ NPI 1639799109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Licenses✔ Licensed in IL · 036.164104✔ Licensed in CA · A176759

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedFamily MedicineTaxonomy 207Q00000X · License A176759 (CA)

Also ListedFamily Medicine · Hospice and Palliative MedicineTaxonomy 207QH0002X · License 036.164104 (IL)

5841 S MARYLAND AVE STE MC6098, Chicago, IL 60637

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Secondary Practice Location 1

Location 1180 Harvester Dr Ste 110Burr Ridge, IL 60527-6686 · Phone (773) 702-1150

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Abrahan Lara-pacheco Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901266410

PECOS Enrollment IDI20230719002869

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RYAN ETCHISON MD

Internal Medicine (Hospice and Palliative Medicine)