Lakeside Nephrology, LTD.

Primary specialty

SpecialistTaxonomy code 174400000X

License

36097354 Issued in IL

Legal business name

LAKESIDE NEPHROLOGY, LTD.

Practice address

9332 Skokie Blvd
Skokie, IL 60077-1309

Phone

(847) 581-0110

Fax

(847) 581-1768

NPI assigned

Jul 2, 2008

Last updated

Jan 31, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

LAKESIDE NEPHROLOGY, LTD.As reported in NPPES

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

Authorized official

Name

Patricia Payne

Title

Practice Manager

Phone

(847) 581-0110

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Lakeside Nephrology LTD4 organizations share this tax ID, including this one

Part of

Lakeside Nephrology LTD

Other organizations with this tax ID 3

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

• Lakeside Nephrolgoy LTD/Prarie

  • Specialist
  • Chicago, IL
  • NPI 1649433376
  NPD tax ID
• Lakeside Nephrology, LTD.

  • Nephrology Physician
  • Chicago, IL
  • NPI 1184779373
  NPD tax ID
• Lakeside Nephrology, LTD.

  • Specialist
  • Chicago, IL
  • NPI 1588827208
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Lakeside Nephrology, LTD.

  • Nephrology Physician
  • Chicago, IL
  • NPI 1184779373
  NPPES parent name

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1386807006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771074",
            "telephone_number": "847-581-0110",
            "fax_number": "847-581-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771309",
            "telephone_number": "847-581-0110",
            "fax_number": "847-581-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE NEPHROLOGY, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKESIDE NEPHROLOGY, LTD.",
        "enumeration_date": "2008-07-02",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-581-0110"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "36097354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Lacey
• Carol Laderman, M.D.
• Laura Lafave, MD
• Lake Shore Gastroenterology
• Lake Shore Gastroenterology
• Anuj Lal, MD
• Khairunisa M Lalani, N.P
• Mogbadounhola Rosaline Laleye
• Mary Lally
• Adam Lam, MD

• Specialist in Skokie, IL
• Providers in Skokie, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.