NPIMap

Organization Active NPI

Northwestern Lake Forest Hospital

Doing business as Northwestern Medicine Lake Forest Hospital

  • General Acute Care Hospital
  • Lake Forest, IL
National Provider Identifier
1124025176
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0001230 Issued in IL
Legal business name
NORTHWESTERN LAKE FOREST HOSPITAL
Doing business as
Northwestern Medicine Lake Forest Hospital
Practice address
1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone
(847) 234-5600
Fax
(847) 535-7846
NPI assigned
Jul 6, 2005
Last updated
Jul 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Seamus P Collins
Title
President
Phone
(847) 535-8683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0001230 IL Primary

Addresses

Primary practice location

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone (847) 234-5600

Other identifiers 1

IdentifierTypeStateIssuer
0084OtherILBLUE CROSS PROVIDER #

Other names 1

  • NORTHWESTERN MEDICINE LAKE FOREST HOSPITAL Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medicaldocumentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090807000139 IL Part A Provider - Hospital 4789672692 Practice locations: Vernon Hills, IL; Lake Forest, IL; Gurnee, IL; Grayslake, IL; Glenview, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124025176. Details of each certification follow.

Hospital certification: CCN 140130

Legal name
NORTHWESTERN LAKE FOREST HOSPITAL
Doing business as
NORTHWESTERN MEDICINE LAKE FOREST HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 30, 1996
Beds
222 (168 certified)
Ownership / control type
Other
Organization structure
OtherNon-profit
Incorporated
Oct 26, 1908 in IL
Enrollment address
1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Northwestern Lake Forest HospitalCCN 140130 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0412982Northwestern Lake Forest Hospital Laboratory1000 N Westmoreland Road - RM 0519, Lake Forest, IL 60045AccreditationFeb 8, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 28

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Seamus P Collins Individual Corporate OfficerPresident Apr 1, 2024
Corporate DirectorBoard Member Apr 1, 2024
W-2 Managing EmployeePresident Apr 1, 2024
Anthony K Kesman Individual Corporate DirectorBoard Member Sep 1, 2018
Jose Carlos Gonzalez-Mendez Individual Corporate DirectorBoard Member Sep 1, 2022
Bahram Ghaderi Individual Corporate DirectorBoard Member Sep 1, 2025
James Zallie Individual Corporate DirectorBoard Member Sep 1, 2018
Michael J Leonard Individual Corporate DirectorBoard Member Sep 1, 2022
Carol L Bernick Individual Corporate DirectorBoard Member Sep 1, 2022
Beatrice Correa Rivera Individual Corporate Director Jun 22, 2025
Ikechukwu I Chineme Individual Corporate DirectorBoard Member Sep 1, 2025
Michael J Mullen Individual Corporate DirectorDirector Rev Cycle Sep 1, 2021
Aaron S Epstein Individual Corporate DirectorBoard Member Sep 1, 2024
John J Guido Individual Corporate DirectorBoard Member Jan 1, 2024
Dean M Harrison Individual Corporate DirectorBoard Member Feb 1, 2010
Kermit R Crawford Individual Corporate DirectorBoard Member Sep 1, 2018
Howard B Chrisman Individual Corporate DirectorBoard Member Jan 1, 2023
Thomas a Carey Individual Corporate DirectorBoard Member Oct 1, 2015
William P Flesch Individual Corporate DirectorBoard Member Sep 1, 2022
Michele C Montpetit Individual Corporate DirectorBoard Member Sep 1, 2024
Charles Ruth Individual Corporate DirectorBoard Member Oct 1, 2015
Joseph R Crane Individual Corporate DirectorBoard Member Sep 1, 2022
Scott P Serota Individual Corporate DirectorBoard Member Sep 1, 2022
Forrest R Whittaker Individual Corporate DirectorBoard Member Sep 1, 2018
James Thorpe Individual Corporate DirectorBoard Member Jan 1, 2018
Northwestern Memorial Healthcare Organization, Chicago, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2010 100%
Kevin Poorten Individual Corporate DirectorBoard Member Sep 1, 2022
Scott L Gwilliam Individual Corporate DirectorBoard Member Sep 1, 2022
Stephen L Davis Individual Corporate DirectorBoard Member Sep 1, 2022
Deborah S Saran Individual Corporate DirectorBoard Member Sep 1, 2018

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

Affiliated clinicians 1,915

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,915

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1124025176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-234-5600",
            "fax_number": "847-535-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-234-5600",
            "fax_number": "847-535-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN LAKE FOREST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-06",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "SEAMUS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-535-8683"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0001230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "0084",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medicaldocumentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NORTHWESTERN MEDICINE LAKE FOREST HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.