Lakefront Emergency Physicians Medical Group, S.C.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

LAKEFRONT EMERGENCY PHYSICIANS MEDICAL GROUP, S.C.

Practice address

4646 N Marine Dr
Chicago, IL 60640-5759

Phone

(877) 346-2211

NPI assigned

Nov 13, 2019

Last updated

Nov 13, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven P Maron, MD

Title

Owner

Phone

(925) 225-5837

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1235774266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4174",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917738174"
        },
        {
            "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": "877-346-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEFRONT EMERGENCY PHYSICIANS MEDICAL GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "MARON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-225-5837",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lakefront Nursing and Rehabilitation LLC

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.