Lakeshore Hospitalist LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-118929 Issued in IL

Legal business name

LAKESHORE HOSPITALIST LLC

Practice address

850 W Irving Park Rd
Chicago, IL 60613-3099

Phone

(414) 530-5082

NPI assigned

Apr 3, 2014

Organization subpart

No

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

Authorized official

Name

Prateek Mishra, M.D.

Title

President

Phone

(414) 530-5082

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1891113130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OLIVE ST",
            "address_2": "SUITE 1",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013013318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133099",
            "telephone_number": "414-530-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE HOSPITALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "PRATEEK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-530-5082",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-118929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, 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 Apr 3, 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.