Lake Shore Pathologists SC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

LAKE SHORE PATHOLOGISTS SC

Practice address

1324 N Sheridan Rd
Vista Medical Center East
Waukegan, IL 60085-2161

Phone

(847) 360-3000

NPI assigned

Jul 19, 2005

Last updated

Nov 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Himani D. Dalia, M.D.

Title

Chair

Phone

(847) 360-3000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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.

• Srinidhi Musunuri, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • Libertyville, IL
  • NPI 1780678920

  Anatomic Pathology & Clinical Pathology

  Medicare reassignment Care Compare group NPD
• Kimiko Suzue, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
  • NPI 1629233408
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1689673055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E. 22ND STREET",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "630-874-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "address_2": "VISTA MEDICAL CENTER EAST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE PATHOLOGISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "DALIA",
        "authorized_official_first_name": "HIMANI",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHAIR",
        "authorized_official_telephone_number": "847-360-3000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake County Health Dept.
• Lake County Immediate Care, LLC (PromptMed Urgent Care)
• Lake County Neurological Associates LTD
• Lake County Physicians Association
• Lake Cunty Health Department
• Carson L Lampert
• Jasmine J Landry
• Meredith Lane, M.A., BCBA
• Georgeanne Judith Langer
• Madison Lapidus

• Anatomic Pathology & Clinical Pathology Physician in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.