Lakeside Eye Group, S.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

042007938 Issued in IL

Legal business name

LAKESIDE EYE GROUP, S.C.

Practice address

180 N Michigan Ave
Suite 1900
Chicago, IL 60601-7401

Phone

(312) 553-1818

Fax

(312) 641-5503

NPI assigned

Jul 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sanjay N Rao, MD

Title

Ophthalmologist

Phone

(312) 553-1818

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Taub Eye Center, s.c Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacy A Symanski, M.D.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1629029038
  NPD (past)
• Joan C Whelchel, M.D.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1912958992
  NPD (past)

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1497954820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-553-1818",
            "fax_number": "312-641-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-553-1818",
            "fax_number": "312-641-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE EYE GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "RAO",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "312-553-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "042007938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER FOR MEDICARE",
            "identifier": "369060",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "31601613",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102488",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taub Eye Center, s.c",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lakeside Community Committee
• Lakeside Dental Center
• Lakeside Dental Center
• Lakeside Dental Center Inc.
• Lakeside Eye Clinic Inc
• Lakeside Medical Group LTD
• Lakeside Nephrolgoy LTD/Prarie
• Lakeside Nephrology, LTD.
• Lakeside Nephrology, LTD.
• Lakeside Oral & Implant Surgery Institute, PC

• All providers in Chicago, IL
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.