Presence Lakeshore Gastroenterology, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PRESENCE LAKESHORE GASTROENTEROLOGY, LLC

Practice address

150 N River Rd
Suite 215
Des Plaines, IL 60016-1272

Phone

(847) 787-1099

NPI assigned

Feb 17, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Lauren Lavaja

Title

Administrator

Phone

(847) 787-1099

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Presence Lakeshore Gastroenterology Dba Des Plaines Endoscopy CenterCCN 14C0001171

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Presence Chicago Hospitals Network

  • Psychiatric Hospital Unit
  • Chicago, IL
  • NPI 1194404251

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1639618036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD",
            "address_2": "SUITE 215",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD",
            "address_2": "SUITE 215",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161272",
            "telephone_number": "847-787-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE LAKESHORE GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "LAVAJA",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-787-1099",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Presence Chicago Hospitals Network
• Presence Health Partners, LLC
• Presence Healthcare Services
• Presence Holy Family Medical Center
• Presence Home Care
• Presence Nazarethville
• Presence Senior Services Chicagoland
• Robert H Priebe, D.C.
• Primary Care Medical Specialists L.L.C
• Primary Care North, SC

• Ambulatory Surgical Clinic/Center in Des Plaines, IL
• Providers in Des Plaines, 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 May 8, 2018; 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.