MARK LYON (NPI# 1831300748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831300748 |
| Entity Type | Individual |
| Full Name | MARK LYON |
| Credential | MD |
| Practice Address |
2850 W 95th St Suite 302 Evergreen Park IL 60805-2735 |
| Mailing Address |
2850 W 95th St Ste 302 Evergreen Park IL 60805-2741 |
| Practice Telephone | 7084222242 |
| Practice Fax Number | 7084222270 |
| Mailing Telephone | 7085817308 |
| Mailing Fax Number | 7082744027 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2016-05-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036116228 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 02232706 | 01 | |
| MEDICARE RAILROAD GROUP NUMBER | DG0826 | 01 | |
| IL | 036116228 | 05 | |
| MEDICAN PTAN | 211475 | 01 | |
| MEDICARE RAILROAD PTAN | P00467991 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447227434 | Mark B Lyon | Family Medicine | 3299 Hilyard St, Eugene, OR 97405-3721 | 2006-03-08 |
| Street Address |
2850 W 95TH ST SUITE 302 |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760480 | Michael R Fiorucci | Surgery | 2850 W 95th St, Suite 306, Evergreen Park, IL 60805-2735 | 2005-06-16 |
| 1295197697 | Shina Keaonis Gordon | Nurse Practitioner | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2016-03-24 |
| 1659757888 | Yvonne Oldaker | Advanced Practice Midwife | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2015-08-11 |
| 1386037984 | Leslie Kelly | Nurse Practitioner | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2015-03-06 |
| 1558754291 | Gina Marie Chigaros | Counselor | 2850 W 95th St, Mary Potter Pavilion Suite 403, Evergreen Park, IL 60805-2735 | 2015-03-05 |
| 1629487806 | Deon Shere Cooper | Registered Nurse | 2850 W 95th St, Suite 301, Evergreen Park, IL 60805-2735 | 2014-08-12 |
| 1750621884 | Cynthia M Hayes | Clinical Nurse Specialist | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2013-02-27 |
| 1336488212 | The Cardiology Group | Clinical Nurse Specialist | 2850 W 95th St, Suite 305, Evergreen Park, IL 60805-2735 | 2013-02-12 |
| 1255608808 | Kunhunn Vellody Md | Clinic/Center | 2850 W 95th St, Suite 201, Evergreen Park, IL 60805-2735 | 2011-11-28 |
| 1457649121 | Ryan Kukor | Internal Medicine | 2850 W 95th St, Suite 102, Evergreen Park, IL 60805-2735 | 2011-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306987896 | Associated Urological Specialists LLC | Urology | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2007-02-09 |
| 1134137417 | Frederick Edward Wohlberg | Urology | 9760 S Kedzie Ave, Suite 6, Evergreen Park, IL 60805-3109 | 2006-08-03 |
| 1619994795 | Herme O Sylora | Urology | 2850 W 95th St, Suite 302, Evergreen Park, IL 60805-2735 | 2006-07-16 |
| 1891751566 | Steven M Pierpaoli | Urology | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2006-04-21 |
| 1245296912 | James A Sylora | Urology | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1912436015 | Robert Ara Petrossian | Urology | 301 N 8th St # 4b143c, Springfield, IL 62701-1041 | 2017-06-12 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1619337912 | George Robert Buckun | Urology | 930 Rogers St., #301, Downers Grove, IL 60515 | 2016-02-29 |
| 1275991606 | Nicole Alyssa Hamilton | Urology | 22285 N Pepper Rd Ste 201, Lake Barrington, IL 60010-2540 | 2016-01-30 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1386053759 | Ramiro Felix Prudencio | Urology | 1200 Broadmeadow Rd, Winnetka, IL 60093-3707 | 2014-08-10 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
| Find all providers with the same taxonomy | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.