NPIMap

Organization Active NPI

Lake Forest Ear Nose and Throat LTD

  • Otolaryngology Physician
  • Lake Forest, IL
National Provider Identifier
1124140652
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036048252 Issued in IL
Legal business name
LAKE FOREST EAR NOSE AND THROAT LTD
Practice address
700 N Westmoreland Rd
BLD F
Lake Forest, IL 60045-1679
Phone
(847) 295-1114
Fax
(847) 295-9373
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Dr. Leslie Jay Block, MD
Title
President
Phone
(847) 295-1114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 036048252 IL Primary

Addresses

Primary practice location

700 N Westmoreland Rd
BLD F
Lake Forest, IL 60045-1679

Mailing address

700 N Westmoreland Rd
BLD F
Lake Forest, IL 60045-1679
Phone (847) 295-1114

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1124140652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N WESTMORELAND RD",
            "address_2": "BLD F",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451679",
            "telephone_number": "847-295-1114",
            "fax_number": "847-295-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N WESTMORELAND RD",
            "address_2": "BLD F",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451679",
            "telephone_number": "847-295-1114",
            "fax_number": "847-295-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST EAR NOSE AND THROAT LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "BLOCK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-295-1114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036048252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.