Active NPI
Lakeshore Anesthesia LTD
- Interventional Pain Medicine Physician
- Chicago, IL
National Provider Identifier
1295945335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- Legal business name
- LAKESHORE ANESTHESIA LTD
- Practice address
- 6145 N Northwest Hwy
Chicago, IL 60631-2127 - Phone
- (312) 809-6500
- Fax
- (312) 809-6501
- NPI assigned
- May 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael H Rock, MD
- Title
- President
- Phone
- (312) 809-6500
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 042619027 | IL | |
| Interventional Pain Medicine Physician | 208VP0014X | Primary |
Addresses
Primary practice location
6145 N Northwest Hwy
Chicago, IL 60631-2127
Mailing address
6145 N Northwest Hwy
Chicago, IL 60631-2127
Phone (312) 809-6500
Other practice location 1
4733 N Damen Ave
Chicago, IL 60625-1442
Phone (312) 809-6500
Other practice location 2
1100 Lake St Ste Ll56
Oak Park, IL 60301-1034
Phone (312) 809-6500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7615080001 | Other | IL | MEDICARE NSC |
Other names 1
- Chicago Institute for Neuropathic Pain
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070816000633 | IL | Part B Supplier - Clinic/Group Practice | 6103918453 |
Receives reassigned benefits from 5 practitioners Practice locations: Chicago, IL; Oak Park, IL |
| O20170825002905 | IL | DME Supplier - Multi-Specialty - Physician | 6103918453 | Practice locations: Chicago, IL |
National Provider Directory
National Provider DirectoryLocations
6145 N Northwest Hwy
Chicago, IL 60631
Phone (857) 706-4907
1100 Lake St
Ste LL56
Oak Park, IL 60301
Phone (404) 631-6156
10 Orland Square Dr
Ste 10C
Orland Park, IL 60462
Phone (708) 942-6030
10 Orland Square Dr
Ste 10B
Orland Park, IL 60462
Practitioners & affiliated clinicians
Practitioners 16
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Interventional Pain Medicine Physician
- Chicago, IL
- NPI 1760596886
Anesthesiology, IL
-
- Anesthesiology Physician
- Glendale Heights, IL
- NPI 1548300809
Anesthesiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1670284800000",
"number": "1295945335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6145 N NORTHWEST HWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606312127",
"telephone_number": "312-809-6500",
"fax_number": "312-809-6501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6145 N NORTHWEST HWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606312127",
"telephone_number": "312-809-6500",
"fax_number": "312-809-6501"
}
],
"practiceLocations": [
{
"address_1": "4733 N Damen Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606251442",
"country_code": "US",
"telephone_number": "312-809-6500",
"fax_number": "312-609-6501",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 Lake St Ste Ll56",
"address_purpose": "LOCATION",
"city": "Oak Park",
"state": "IL",
"postal_code": "603011034",
"country_code": "US",
"telephone_number": "312-809-6500",
"fax_number": "312-809-6501",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LAKESHORE ANESTHESIA LTD",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-23",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A",
"authorized_official_last_name": "ROCK",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "312-809-6500",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": "IL",
"license": "042619027",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NSC",
"identifier": "7615080001",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Chicago Institute for Neuropathic Pain",
"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 Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.