LAKE SHORE MEDICAL SERVICES (NPI# 1881766509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881766509 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE MEDICAL SERVICES |
| Practice Address |
680 N Lake Shore Dr Suite 115 Chicago IL 60611-4546 |
| Practice Telephone | 3126545583 |
| Practice Fax Number | 3126545580 |
| Mailing Telephone | 3126545583 |
| Mailing Fax Number | 3126545580 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BONNIE E. WISE (DIRECTOR) |
| Authorized Official Telephone | 3126545583 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Street Address |
680 N LAKE SHORE DR SUITE 115 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-4546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427052885 | Jeanette A. Dubay-mcdermit | Nurse Anesthetist, Certified Registered | 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611-4546 | 2005-06-13 |
| 1023621406 | Akshar Patel | Student in an Organized Health Care Education/Training Program | 680 N Lake Shore Dr, Tower Apt 720, Chicago, IL 60611 | 2020-08-26 |
| 1952873267 | Kimberly Sumislawski | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-12-27 |
| 1598251571 | Asia Giammarco | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-07-02 |
| 1497253256 | Samantha M C Tan | Nurse Practitioner | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-01-26 |
| 1871040642 | Kathleen Dady | Genetic Counselor, MS | 680 N Lake Shore Dr, Suite 1230, Chicago, IL 60611-4546 | 2016-09-08 |
| 1205382496 | Rachel Green Dunn | Nurse Practitioner | 680 N Lake Shore Dr, Suite 117, Chicago, IL 60611-4546 | 2016-08-29 |
| 1730634791 | Kelly Elizabeth Smyth | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611 | 2016-08-19 |
| 1982158036 | Patricia Gale, Md, S.c. | Clinic/Center | 680 N Lake Shore Dr, Suite 930, Chicago, IL 60611-4546 | 2016-08-06 |
| 1013460930 | Julia Goldin | Registered Nurse | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2016-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1437612405 | Voice of Reason Counseling, LLC | Clinic/Center | 6634 S Knox Ave, Chicago, IL 60629-5643 | 2019-04-08 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1184122509 | First Call Network, LLC | Clinic/Center | 8725 W Higgins Rd Ste 110, Chicago, IL 60631-2710 | 2018-01-31 |
| 1164952362 | Franklin Eye Care, LLC | Clinic/Center | 227 W Monroe St Lbby 160, Chicago, IL 60606-5091 | 2017-06-19 |
| 1770027567 | Eating Recovery Center | Clinic/Center | 3121 Augusta Blvd, Apt 3, Chicago, IL 60622 | 2016-12-13 |
| 1619428273 | 360 Active Recovery | Clinic/Center | 2221 W North Ave, #1, Chicago, IL 60647-5429 | 2016-10-19 |
| 1992158562 | Illinois Wellness and Weight Loss Centers Sc | Clinic/Center | 9933 South Western Avenue, Suite 200, Chicago, IL 60643-1810 | 2016-07-19 |
| Find all providers in CHICAGO | ||||
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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.