Aurora Chicago Lakeshore Hospital, LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

0005207 Issued in IL

Legal business name

AURORA CHICAGO LAKESHORE HOSPITAL, LLC

Doing business as

Aurora Chicago Lakeshore Hospital Children's Pavilion

Practice address

4720 Clarendon Road
Chicago, IL 60640-7860

Phone

(773) 878-9700

Fax

(773) 907-4607

NPI assigned

May 22, 2014

Last updated

May 28, 2014By 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

Mr. Alan Eaks

Title

Ceo

Phone

(773) 907-4600

Specialties & licenses 1

Addresses

Other names 1

• Aurora Chicago Lakeshore Hospital Children's Pavilion Doing business as

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.

• Martin Neil Paisner, MD

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1588635411
  NPD (past)

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1790197978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407860",
            "telephone_number": "773-878-9700",
            "fax_number": "773-907-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 CLARENDON ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407860",
            "telephone_number": "773-878-9700",
            "fax_number": "773-907-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA CHICAGO LAKESHORE HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "EAKS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-907-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "IL",
            "license": "0005207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aurora Chicago Lakeshore Hospital Children's Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric Hospital in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatric Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.