Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ricardo Lastra

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1053576389

Ricardo Lastra is a Pathology in Chicago, Illinois. Qualified in 2005, 21 years ago. Practices with University of Chicago, a 1,681-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
21
Licensed in
IL
In the registry since
2008
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Practice location Address checks out

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone: (888) 824-0200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 036137663 (IL)

Record details

NPI number1053576389
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 25, 2008
Last updated in NPPESOctober 24, 2022
Mailing address150 Harvester Dr, Suite 300, Burr Ridge, IL 60527-5919

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice University Of Chicago — 1681 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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