Active NPI
Lakeside Nephrolgoy LTD/Prarie
- Specialist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 36-065928
- Legal business name
- LAKESIDE NEPHROLGOY LTD/PRARIE
- Practice address
- 1717 S Wabash Ave
Chicago, IL 60616-1219 - Phone
- (312) 913-0110
- Fax
- (312) 913-9154
- NPI assigned
- Jul 2, 2008
- Last updated
- Jul 2, 2008
- Organization subpart
- Yes
- Parent organization
- LAKESIDE NEPHROLOGY LTD/LOOP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Sheldon Hirsch, MD
- Title
- Partner
- Phone
- (312) 913-0110
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 36-065928 | IL | Primary |
Addresses
Primary practice location
1717 S Wabash Ave
Chicago, IL 60616-1219
Mailing address
1717 S Wabash Ave
Chicago, IL 60616-1219
Phone (312) 913-0110
National Provider Directory
National Provider Directory- Tax ID family
- Lakeside Nephrology LTD
- Part of
- Lakeside Nephrology LTD
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nephrology Physician
- Chicago, IL
- NPI 1184779373
-
- Specialist
- Skokie, IL
- NPI 1386807006
-
- Specialist
- Chicago, IL
- NPI 1588827208
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Nephrology Physician
- Chicago, IL
- NPI 1174509020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214956800000",
"number": "1649433376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 S WABASH AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606161219",
"telephone_number": "312-913-0110",
"fax_number": "312-913-9154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S WABASH AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606161219",
"telephone_number": "312-913-0110",
"fax_number": "312-913-9154"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKESIDE NEPHROLGOY LTD/PRARIE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LAKESIDE NEPHROLOGY LTD/LOOP",
"enumeration_date": "2008-07-02",
"last_updated": "2008-07-02",
"status": "A",
"authorized_official_last_name": "HIRSCH",
"authorized_official_first_name": "SHELDON",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "312-913-0110",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "IL",
"license": "36-065928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.