Lake Villa Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKE VILLA INTERNAL MEDICINE

Practice address

50 S Milwaukee Ave
Ste 104
Lake Villa, IL 60046

Phone

(847) 356-2700

Fax

(847) 356-2777

NPI assigned

Apr 18, 2006

Organization subpart

No

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

Authorized official

Name

Corrado Ugolini, MD

Title

President

Phone

(847) 356-2700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861457558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S MILWAUKEE AVE",
            "address_2": "STE 104",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-356-2700",
            "fax_number": "847-356-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S MILWAUKEE AVE",
            "address_2": "STE 104",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-356-2700",
            "fax_number": "847-356-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE VILLA INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UGOLINI",
        "authorized_official_first_name": "CORRADO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-356-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Douglas Kulb, PSY.D.
• Aarti Kulkarni, M.D.
• Lake County Health Department
• Lake Villa CCSD 41
• Lake Villa Fire Protection District
• Michelle K Laplante, LCSW
• Alexis Desarae Laporta, LCSW
• Rebecca L Lara, DPT
• Melissa Anne Lemke
• Courtney Leonard, SLP

• Internal Medicine Physician in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.