Lakeshore Cancer Care,LTD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

3651679 Issued in IL

Legal business name

LAKESHORE CANCER CARE,LTD

Practice address

5020 N Ashland Ave
Chicago, IL 60640-2880

Phone

(773) 506-0900

Fax

(773) 506-0909

NPI assigned

Mar 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nam E Kim, M.D.

Title

President

Phone

(847) 501-3927

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1689706111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 WINNETKA AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933539",
            "telephone_number": "847-501-3927",
            "fax_number": "847-501-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402880",
            "telephone_number": "773-506-0900",
            "fax_number": "773-506-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE CANCER CARE,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "NAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-501-3927",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "3651679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lakeshore Anesthesia LTD
• Lakeshore Cco Inc
• Lakeshore Center for Behavioral Health, LLC
• Lakeshore Community Chiropractic Clinic, P.C.
• Lakeshore Counseling Group, PLLC
• Lakeshore Eye Physicians and Surgeons SC

• All providers in Chicago, IL
• Radiation Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.