Lake Forest Cardiology

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036088401 Issued in IL

Legal business name

LAKE FOREST CARDIOLOGY

Practice address

611 Hunter LN
Lake Forest, IL 60045-4905

Phone

(847) 615-2273

NPI assigned

Oct 18, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Srish Sriram

Title

Member

Phone

(847) 615-2273

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1437434800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 HUNTER LN",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600454905",
            "telephone_number": "847-615-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 HUNTER LN",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600454905",
            "telephone_number": "847-615-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST CARDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "SRIRAM",
        "authorized_official_first_name": "SRISH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-615-2273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036088401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Byungchul Kwak, DO
• Alex B Labby, MD
• Kevin M Lage
• Colleen Marie Lahendro, APRN, CNP
• Lake County Crisis Center for the Prevention and Treatment of Domestic
• Lake Forest Cardiology LLC
• Lake Forest Comm H S Dist 115
• Lake Forest Dental Associates
• Lake Forest Dental Associates, PC
• Lake Forest Ear Nose and Throat LTD

• Cardiovascular Disease Physician in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.