LAKE SHORE PATHOLOGISTS SC (NPI# 1689673055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689673055 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE PATHOLOGISTS SC |
| Practice Address |
1324 N Sheridan Rd Vista Medical Center East Waukegan IL 60085-2161 |
| Mailing Address |
520 E. 22nd Street Lombard IL 60148 |
| Practice Telephone | 8473603000 |
| Mailing Telephone | 6308742542 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2007-11-27 |
| Authorized Official Name | HIMANI D. DALIA (CHAIR) |
| Authorized Official Telephone | 8473603000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| Street Address |
1324 N SHERIDAN RD VISTA MEDICAL CENTER EAST |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-2161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528689817 | Andrew Joseph Quinlan | Pharmacist | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2020-04-28 |
| 1891324281 | Tyler Stenger | Registered Nurse | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2020-04-07 |
| 1851936272 | Natalie Anne Butler | Nurse Practitioner | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2019-11-08 |
| 1720635170 | Kathleen Trinh | Nurse Practitioner | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2019-08-21 |
| 1386114858 | Krina D Patel | Nurse Practitioner | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2018-11-28 |
| 1447728183 | Paolo Petilla Mercado | Nurse Practitioner | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2018-11-12 |
| 1427539279 | Robert R Cashen | Physician Assistant | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2018-08-28 |
| 1437667037 | Leigh Ann Jones | Physician Assistant | 1324 N Sheridan Rd, Waukegan, IL 60085 | 2018-01-17 |
| 1033635818 | Kathleen Elizabeth Ready | Dietitian, Registered | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2017-08-14 |
| 1184151193 | Haili M Campanella | Registered Nurse | 1324 N Sheridan Rd, Waukegan, IL 60085-2161 | 2017-05-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780684670 | Himani D. Dalia | Pathology | 2615 Washington St, St. Therese Medical Center, Waukegan, IL 60085-4980 | 2005-07-21 |
| 1386967776 | Harold Lance Evans | Pathology | 1324 N Sheridan Rd, Vista Health Center East Dept of Pathology, Waukegan, IL 60085-2161 | 2010-03-12 |
| 1487654307 | Hwaja L. Rhee | Pathology | 2615 Washington St, St. Therese Medical Center, Waukegan, IL 60085-4980 | 2005-07-22 |
| 1174523013 | Barry L Mullen | Pathology | 2615 Washington St, St. Therese Medical Center, Waukegan, IL 60085-4980 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255930145 | Uttamjot Kaur | Pathology | 2650 Ridege Avenue, Evanston Hospital, Chicago, IL 60613-6061 | 2020-10-21 |
| 1770131831 | Reditus Laboratories | Pathology | 1805 Riverway Dr, Pekin, IL 61554-9309 | 2019-08-30 |
| 1679137756 | Hans-magne Hansen Hamnvag | Pathology | 2460 S 1st Avenue Loyola University Medical Center, Maywood, IL 60153-3328 | 2019-04-24 |
| 1497229157 | Almasri Medical LLC | Pathology | 8150 185th St Ste A, Tinley Park, IL 60487-9319 | 2019-01-16 |
| 1689188062 | Karina Colossi Furlan | Pathology | 1750 W Harrison St Fl 5, Chicago, IL 60612-3825 | 2017-11-21 |
| 1245753961 | Ayse Irem Kilic | Pathology | 2160 South First Ave., Maywood, IL 60153-3328 | 2017-07-25 |
| 1073967162 | Lucy Fu | Pathology | 303 East Chicago Avenue Ward 3-140 W127, Chicago, IL 60611-1059 | 2016-04-14 |
| 1679930457 | Lindsay Alpert | Pathology | 150 Harvester Drive, Suite 300, Burr Ridge, IL 60527-6686 | 2016-01-25 |
| 1831573898 | Indu Agarwal | Pathology | 2100 Valencia Dr, #314b, Northbrook, IL 60062-7063 | 2015-07-18 |
| 1053790113 | Lisa Han | Pathology | 5841 S. Maryland Ave., Rm. S323, Mc 3083, Chicago, IL 60637-1470 | 2015-05-22 |
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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.