Lake North Institute LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

036096374 Issued in IL

Legal business name

LAKE NORTH INSTITUTE LLC

Practice address

1247 Milwaukee Ave
Glenview, IL 60025-2464

Phone

(847) 298-2200

Fax

(847) 298-2299

NPI assigned

Jun 28, 2011

Organization subpart

No

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

Authorized official

Name

Alexander Gorodetsky, M.D

Title

Physician

Phone

(847) 298-2200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1073809000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 BEACH RD",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 MILWAUKEE AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252464",
            "telephone_number": "847-298-2200",
            "fax_number": "847-298-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORTH INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "GORODETSKY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-298-2200",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036096374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo Julian Ladlad, M.D.
• Natalie Laduke, PHD
• Jaime Lagunas, COTA
• Charre Leanette Laing
• Lake Family Dental
• Lake Shore Gastroenterology
• Aliya Ferozali Lakhani, APN-CNP
• Kathryn Kelly Lalonde, ATC
• Kathryn Mary Lamermayer Flaherty, L.C.S.W.
• Kristine M Lamermayer, OT

• Specialist in Glenview, IL
• Providers in Glenview, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.