Lake Shore Medical Consultants, S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKE SHORE MEDICAL CONSULTANTS, S.C.

Practice address

2800 N Sheridan Rd
Suite 203
Chicago, IL 60657-6156

Phone

(773) 404-5263

Fax

(773) 404-1867

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Lynda Lane, MD

Title

Ceo

Phone

(773) 404-5263

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1417021551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-404-5263",
            "fax_number": "773-404-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-404-5263",
            "fax_number": "773-404-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE MEDICAL CONSULTANTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-404-5263",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "0031604330",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Shore Foot & Ankle PC
• Lake Shore Foot & Ankle, PC
• Lake Shore Healthcare & Rehabilitation Centre LLC
• Lake Shore Medical Associates LTD (Vijayalakshmi Arekapudi MD)
• Lake Shore Medical Associates, LTD.
• Lake Shore Medical Services
• Lake Shore Medicar, Inc.
• Lake Shore Mental Health Services
• Lake Shore Plastic Surgery
• Lake Shore Podiatry Center, LLC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.