Lakeside Anesthesiology, SC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

LAKESIDE ANESTHESIOLOGY, SC

Practice address

6090 Strathmoor Dr
Rockford, IL 61107-6628

Phone

(815) 633-8586

NPI assigned

May 25, 2006

Last updated

Jun 6, 2011By 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

David S Footerman, MDNPI 1629023817

Title

President

Phone

(815) 633-8586

Specialties & licenses 2

Addresses

Locations

Practitioners 3

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.

• David S Footerman, MD

  • Pain Medicine (Anesthesiology) Physician
  • Rockford, IL
  • NPI 1629023817
  Authorized official Same address or phone
• Sina Bahmanyar, MD

  • Ophthalmology Physician
  • Rockford, IL
  • NPI 1174579577
  NPD (past)
• Jerome S Weiskopf, MD

  • Surgery of the Hand (Surgery) Physician
  • Rockford, IL
  • NPI 1992814628
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1306892377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 WEAVER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148055",
            "telephone_number": "815-633-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6090 STRATHMOOR DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076628",
            "telephone_number": "815-633-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE ANESTHESIOLOGY, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "FOOTERMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-633-8586",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Wiedemer Laib, MD
• Lake County Physicians Association
• Abigail Diane Lake, DNP, PMHNP-BC
• Lakeshore Clinical LLC
• Lakeside Anesthesiology, S.C (1Body4Life)
• Radhikaben Lakhani
• June Upshaw Lallas, DDS
• Gabrielle Lalor, LPC
• Kasondra M Lamere, APRN
• Patricia S Land, COTA

• Pain Medicine (Anesthesiology) Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.