Damon Lake Media

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DAMON LAKE MEDIA

Practice address

1624 W Division St Apt 208
Chicago, IL 60622-3908

Phone

(312) 391-9206

NPI assigned

Jan 21, 2025

Organization subpart

No

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

Authorized official

Name

Joshua Lustig

Title

Owner

Phone

(312) 391-9206

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1740092477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N OGDEN AVE # 195",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606426421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 W DIVISION ST APT 208",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223908",
            "telephone_number": "312-391-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMON LAKE MEDIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "LUSTIG",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-391-9206"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Damman, RDN
• Laurel Ann Dammann, LCSW
• Jenell Stacey Dammar, MED
• Ashvini Damodaran, M.D.
• Sudarshawn Damodharan, DO
• Victoria Rose Damore, MD
• Patricia Dianne Damper, MD
• Samar Damra
• Ninna Damrongsan, DPT
• Melissa Ramos Damrongvachiraphan, MS, CGC

• Durable Medical Equipment & Medical Supplies in Chicago, IL
• Providers in Chicago, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.