LAKE SHORE GASTROENTEROLOGY (NPI# 1467578294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467578294 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE GASTROENTEROLOGY |
| Practice Address |
20 Tower Ct Suite C Gurnee IL 60031-5711 |
| Practice Telephone | 8472442960 |
| Practice Fax Number | 8472442986 |
| Mailing Telephone | 8472442960 |
| Mailing Fax Number | 8472442986 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-08-27 |
| Authorized Official Name | WALTER REID GLAWS (PRESIDENT) |
| Authorized Official Telephone | 8472442960 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932225836 | Lake Shore Gastroenterology | Internal Medicine | 9701 Knox Ave, Suite 103, Skokie, IL 60076-1256 | 2007-03-22 |
| 1700902616 | Lake Shore Gastroenterology | Internal Medicine | 2501 Compass Rd, Suite 2501, Glenview, IL 60026-8000 | 2007-03-22 |
| 1275659187 | Lake Shore Gastroenterology | Internal Medicine | 9700 Kenton Ave, Suite 100, Skokie, IL 60076-1259 | 2007-03-22 |
| 1205952686 | Lake Shore Gastroenterology | Internal Medicine | 806 Central Ave, Suite 202, Highland Park, IL 60035-5613 | 2007-03-21 |
| 1588780894 | Lake Shore Gastroenterology | Internal Medicine | 800 Austin St, Suite 403 West Tower, Evanston, IL 60202-3439 | 2007-03-21 |
| Street Address |
20 TOWER CT SUITE C |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-5711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003817180 | Fred B Rosenberg | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2005-08-10 |
| 1700288164 | Geena R. Patel Dds PC | Dentist | 20 Tower Ct, Suite D, Gurnee, IL 60031-5711 | 2014-09-17 |
| 1144587973 | Jg Johnson Chiropractic Office PC | Chiropractor | 20 Tower Ct, Suite B, Gurnee, IL 60031-5711 | 2012-04-18 |
| 1811150725 | Jonathan Alan Rosenberg | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2008-07-10 |
| 1316111388 | Rashmikant S.patel M.d.s.c. | Clinic/Center | 20 Tower Ct, Suite D, Gurnee, IL 60031-5711 | 2008-04-21 |
| 1386818557 | Dor Heart & Vascular, PC | Internal Medicine | 20 Tower Ct, Suite F, Gurnee, IL 60031-5711 | 2008-04-17 |
| 1437333747 | Scheer Surgical Sc | Surgery | 20 Tower Ct, Suite A, Gurnee, IL 60031-5711 | 2007-12-21 |
| 1215063144 | Lake Shore Gastroenterolgy Sc | Pathology | 20 Tower Ct, Suite C, Gurnee, IL 60031 | 2007-02-26 |
| 1922184225 | Jeffrey Glen Johnson | Chiropractor | 20 Tower Ct, Suite B, Gurnee, IL 60031-5711 | 2006-10-29 |
| 1386747731 | Daniel A Liesen | Surgery | 20 Tower Ct, Ste A, Gurnee, IL 60031-5711 | 2006-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979729 | Hosep H Deyrmenjian | Internal Medicine | 1445 Hunt Club Rd, Ste 303, Gurnee, IL 60031 | 2005-08-16 |
| 1003817180 | Fred B Rosenberg | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2005-08-10 |
| 1194727420 | John W Matseshe | Internal Medicine | 1445 N Hunt Club Rd Ste 303, Gurnee, IL 60031-2603 | 2005-05-31 |
| 1487284881 | John W Matseshe Md Pllc | Internal Medicine | 1445 N Hunt Club Rd Ste 303, Gurnee, IL 60031-2603 | 2020-01-24 |
| 1811150725 | Jonathan Alan Rosenberg | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2008-07-10 |
| 1043482250 | Hosep H Deyrmenjian, Md, PC | Internal Medicine | 6440 Grand Ave, Suite 205, Gurnee, IL 60031-5257 | 2008-03-27 |
| 1104828532 | Walter Reid Glaws | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2005-08-15 |
| 1225030687 | Everett P Kirch | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2005-08-15 |
| 1447252804 | Cynthia A Wait | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2005-08-15 |
| 1235131673 | Kevin Liebovich | Internal Medicine | 20 Tower Ct, Suite C, Gurnee, IL 60031-5711 | 2005-08-15 |
| Find all providers in GURNEE | ||||
Please comment or provide details below to improve the information on LAKE SHORE GASTROENTEROLOGY.
| 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.