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DR. MALLORY M. LOGSDON D.O.
NPI 1831480896
Pediatrics in Libertyville, IL

Active since April 26, 2011PECOS Enrolled
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048(847) 990-5450(847) 573-4287 Get Directions Write a Review

NPPES record last updated: March 6, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Mallory M. Logsdon D.o. NPPES

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

DR. MALLORY M. LOGSDON D.O. (NPI 1831480896) is an individual pediatrics provider in Libertyville, Illinois, licensed in Illinois (036.135544) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1831480896
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MALLORY M. LOGSDONCredential: D.O.
Location Address801 S MILWAUKEE AVELibertyville, IL 60048-3204
Mailing Address29373 Network PlChicago, IL 60673-1293 · (847) 390-5900
Phone(847) 990-5450
Fax(847) 573-4287
Sole ProprietorYes
Enumeration DateApril 26, 2011
Last NPPES UpdateMarch 6, 2025
NPPES CertifiedMarch 6, 2025
✔ NPI 1831480896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 036.135544
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
801 S MILWAUKEE AVE, Libertyville, IL 60048
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mallory M. Logsdon D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60048 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. ANNA MAE STEGEMANN D.O.
Anesthesiology
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 990-2135
MAUREEN FRITZ DPT
Physical Therapist
801 S MILWAUKEE AVE, REHAB DEPARTMENT
LIBERTYVILLE, IL 60048
Lake County (847) 990-5350
DR. DEAN JOSEPH CONTERATO MD
Radiology (Radiation Oncology)
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 990-5910
GLORIA BOLAND BSN, RN, CDCES
Registered Nurse (Diabetes Educator)
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 990-5579
CONDELL MEDICAL CENTER
General Acute Care Hospital
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 362-2900
MARINA LYUBKIN
Nurse Practitioner
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 362-2900
IHC-LIBERTYVILLE EMERGENCY PHYSICIANS, LLC
Emergency Medicine
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (414) 290-6718
DR. DIMITRIOS T. MOUGOLIAS M.D.
Emergency Medicine
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 990-2075

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Logsdon's NPI number?

The NPI number for Mallory Logsdon is 1831480896. It was assigned to this individual provider in the NPPES registry on April 26, 2011.

Where is Mallory Logsdon located?

Mallory Logsdon practices at 801 S Milwaukee Ave, Libertyville, IL 60048. The listed phone number is (847) 990-5450.

What is Mallory Logsdon's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mallory Logsdon enrolled in Medicare?

Yes. Mallory Logsdon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mallory Logsdon was last updated on March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.