Jacob S Lake, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

2806 W Devon Ave
Chicago, IL 60659-1502

Phone

(773) 973-1100

Fax

(773) 973-1531

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• O Guterzon DDS LTD

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1942516067
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811979933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MISSION HILLS RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625750",
            "telephone_number": "847-562-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591502",
            "telephone_number": "773-973-1100",
            "fax_number": "773-973-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JACOB",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Shore Podiatry Center, LLC
• Lake Shore Podiatry Center, LLC
• Lake Shore Surgical Associates, LTD.
• Lake Shore Therapy Center, Inc.
• Lake View Dental Associates, PC
• Jennifer Zang Lake, LPC
• Mary E. Lake, M.D.
• Lakefront Counseling Group, LTD.
• Lakefront Emergency Physicians Medical Group, S.C.
• Lakefront Medical Associates LLC (Vanguard Medical Group - Lakefront)

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.