Provider Demographics
NPI:1174599831
Name:LEHMAN, KARL DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:DOUGLAS
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2204
Mailing Address - Country:US
Mailing Address - Phone:847-328-8358
Mailing Address - Fax:847-328-8359
Practice Address - Street 1:707 MADISON ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2204
Practice Address - Country:US
Practice Address - Phone:847-328-8358
Practice Address - Fax:847-328-8359
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360856952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001606938OtherBLUECROSS BLUESHIELD PRV#
F10649Medicare UPIN
IL360260Medicare ID - Type Unspecified