Lakeshore Home Visiting Physicians

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LAKESHORE HOME VISITING PHYSICIANS

Practice address

5232 N Sheridan Rd
Chicago, IL 60640-2513

Phone

(773) 654-3326

NPI assigned

Mar 31, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Arnette McKenzie

Title

Owner/Operator

Phone

(773) 654-3326

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Lakeshore Home Visiting Physicians2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lakeshore Home Visiting Physicians

  • Home Health Agency
  • Chicago, IL
  • NPI 1831818558
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olusoji Anthony Peter, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1225018203
  Medicare reassignment Care Compare group NPD
• Rudyard Uriah Smith, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1295784031
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1063152734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5232 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402513",
            "telephone_number": "773-654-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5232 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402513",
            "telephone_number": "773-654-3326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4339 S Michigan Ave Apt 2N",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606535258",
            "country_code": "US",
            "telephone_number": "312-983-0583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKESHORE HOME VISITING PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "ARNETTE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "773-654-3326"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.lakeshorehomedoc.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging  Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Telephone",
            "address_1": "4339 S Michigan Ave Apt 2N",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606535258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ap.lakeshorehomedoc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "5232 N Sheridan Rd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606402513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lakeshore Cco Inc
• Lakeshore Center for Behavioral Health, LLC
• Lakeshore Community Chiropractic Clinic, P.C.
• Lakeshore Counseling Group, PLLC
• Lakeshore Eye Physicians and Surgeons SC
• Lakeshore Home Visiting Physicians
• Lakeshore Hospitalist LLC
• Lakeshore Infectious Disease Associates LTD.
• Lakeshore Infectious Diseases Consultant Corporation
• Lakeshore Integrative Healthcare, LTD

• Home Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.