NPIMap

Organization Active NPI

Lake Shore Plastic Surgery

  • Specialist
  • Chicago, IL
National Provider Identifier
1306142872
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036092789 Issued in IL
Legal business name
LAKE SHORE PLASTIC SURGERY
Practice address
60 E Delaware PL
15TH FL
Chicago, IL 60611-1998
Phone
(312) 202-9000
Fax
(312) 202-9002
NPI assigned
Feb 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Authorized official

Name
Michael Alan Horn, M.D.NPI 1326230434
Title
President
Phone
(312) 202-9000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036092789 IL Primary

Addresses

Primary practice location

60 E Delaware PL
15TH FL
Chicago, IL 60611-1998

Mailing address

60 E Delaware PL
15TH FL
Chicago, IL 60611-1998
Phone (312) 202-9000

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": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1306142872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E DELAWARE PL",
            "address_2": "15TH FL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111998",
            "telephone_number": "312-202-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E DELAWARE PL",
            "address_2": "15TH FL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111998",
            "telephone_number": "312-202-9000",
            "fax_number": "312-202-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "HORN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-202-9000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036092789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 1, 2011; 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.