Healthcare Provider Details

I. General information

NPI: 1285826404
Provider Name (Legal Business Name): LUDMIL LAZAROV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2007
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S WOOD ST # MC793
CHICAGO IL
60612-4325
US

IV. Provider business mailing address

989 SPRING MILL DR
HOFFMAN ESTATES IL
60169-1665
US

V. Phone/Fax

Practice location:
  • Phone: 773-715-8034
  • Fax:
Mailing address:
  • Phone: 773-715-8034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number51870-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number119398
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD491082C
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberCDR.0001181
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: