NPIMap

Organization Active NPI

Lakeshorehealthcare

  • Group Psychotherapy Psychologist
  • Chicago, IL
National Provider Identifier
1881643906
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Legal business name
LAKESHOREHEALTHCARE
Practice address
4444 W Montrose Ave
Chicago, IL 60641-2023
Phone
(773) 286-0668
Fax
(773) 286-0554
NPI assigned
May 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jay Soble
Title
Secretary
Phone
(773) 286-0668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X Primary

Addresses

Primary practice location

4444 W Montrose Ave
Chicago, IL 60641-2023

Mailing address

4444 W Montrose Ave
Chicago, IL 60641-2023
Phone (773) 286-0668

National Provider Directory

National Provider Directory

Locations

4444 W Montrose Ave
Chicago, IL 60641
Phone (773) 286-0668

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881643906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412023",
            "telephone_number": "773-286-0668",
            "fax_number": "773-286-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412023",
            "telephone_number": "773-286-0668",
            "fax_number": "773-286-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHOREHEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOBLE",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "773-286-0668",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • 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.