NPIMap

Organization Active NPI

Lakefront Medical Associates LLC

Doing business as Vanguard Medical Group - Lakefront

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1144418633
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAKEFRONT MEDICAL ASSOCIATES LLC
Doing business as
Vanguard Medical Group - Lakefront
Practice address
4646 N Marine Dr
Chicago, IL 60640-5759
Phone
(773) 564-5102
Fax
(773) 564-5101
NPI assigned
Oct 9, 2007
Last updated
Mar 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Craig C. Armin
Title
VP of Govt Programs, Tenet
Phone
(818) 436-2267

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X

Addresses

Primary practice location

4646 N Marine Dr
Chicago, IL 60640-5759

Mailing address

20 Burton Hills Blvd
Nashville, TN 37215-6197
Phone (615) 665-6000

Other names 1

  • Vanguard Medical Group - Lakefront Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1923 W Montrose Ave
Chicago, IL 60613
Phone (773) 281-8855

4646 N Marine Dr
Fl 1
Chicago, IL 60640
Phone (773) 564-5030

4646 N Marine Dr
Fl 3
Chicago, IL 60640
Phone (773) 564-6060

4646 N Marine Dr
Fl 6
Chicago, IL 60640
Phone (773) 564-6150

5528 N Milwaukee Ave
Chicago, IL 60630
Phone (773) 564-6150

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/684/brand/2/csg/43/fhir/r4

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1144418633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BURTON HILLS BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156197",
            "telephone_number": "615-665-6000",
            "fax_number": "615-665-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-564-5102",
            "fax_number": "773-564-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEFRONT MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "ARMIN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "VP OF GOVT PROGRAMS, TENET",
        "authorized_official_telephone_number": "818-436-2267"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vanguard Medical Group - Lakefront",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vanguard Medical Group - Lakefront",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.