Lincoln Park Open MRI, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

LINCOLN PARK OPEN MRI, LLC

Doing business as

Lakeside Open MRI

Practice address

812 W Chicago Ave
East Chicago, IN 46312-3307

Phone

(219) 392-8888

Fax

(219) 392-8812

NPI assigned

Mar 23, 2007

Last updated

Aug 22, 2020By 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

Mr. Raghu Nayak

Title

President

Phone

(219) 392-8888

Specialties & licenses 1

Addresses

Other names 1

• LAKESIDE OPEN MRI Doing business as

Tax ID family

Lake Shore Open MRI CT2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lincoln Park Open MRI, LLC

  dba Lake Shore Open MRI & CT

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1164548756
  NPD tax ID

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326165465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451812",
            "telephone_number": "773-761-0200",
            "fax_number": "773-761-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W CHICAGO AVE",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123307",
            "telephone_number": "219-392-8888",
            "fax_number": "219-392-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PARK OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAYAK",
        "authorized_official_first_name": "RAGHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-392-8888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKESIDE OPEN MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Latasha Lewis, RN
• Robbin Desiree Lewis Jr.
• Sylvania Regina Lewis
• Matthew A R Libiran, MD
• Tracy Lige
• Tonya L. Lindsay
• Lillian Lira
• Shaunice Little
• Dawna Locke-Major, BSW
• Karen Lounsbury, PT

• Diagnostic Radiology Physician in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.