Lake Bluff Il Endoscopy ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7002926 Issued in IL

Legal business name

LAKE BLUFF IL ENDOSCOPY ASC LLC

Practice address

101 S Waukegan Rd
Suite 980
Lake Bluff, IL 60044-3012

Phone

(847) 604-8700

Fax

(847) 604-8711

NPI assigned

Feb 20, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey E. Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other names 1

• North Shore Endoscopy Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

North Shore Endoscopy CenterCCN 14C0001075

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1497720999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156153",
            "telephone_number": "615-240-3741",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S WAUKEGAN RD",
            "address_2": "SUITE 980",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600443012",
            "telephone_number": "847-604-8700",
            "fax_number": "847-604-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE BLUFF IL ENDOSCOPY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Endoscopy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Shore Endoscopy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lake Bluff Acupuncture, LLC
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• Lake Bluff School District 65
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• Hayley Lakin
• Lawrence a Short DPM LTD

• Ambulatory Surgical Clinic/Center in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.