Lake Shore Healthcare & Rehabilitation Centre LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAKE SHORE HEALTHCARE & REHABILITATION CENTRE LLC

Practice address

7200 N Sheridan Rd
Chicago, IL 60626-2613

Phone

(773) 973-7200

NPI assigned

Dec 18, 2009

Organization subpart

No

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

Authorized official

Name

Nesanel Davis

Title

Administrator

Phone

(773) 463-1313

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1700115805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 W PETERSON AVE",
            "address_2": "SUITE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606262613",
            "telephone_number": "773-973-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE HEALTHCARE & REHABILITATION CENTRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NESANEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-463-1313"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Shore Anesthesia Associates, LLC
• Lake Shore Cardiology Group, LTD.
• Lake Shore Care Center LLC
• Lake Shore Foot & Ankle PC
• Lake Shore Foot & Ankle, PC
• Lake Shore Medical Associates LTD
• Lake Shore Medical Associates, LTD.
• Lake Shore Medical Consultants, S.C.
• Lake Shore Medical Services
• Lake Shore Medicar, Inc.

• Skilled Nursing Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.