Active NPI
Chicago Lake Shore Medical Associates,LTD
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1912946120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- CHICAGO LAKE SHORE MEDICAL ASSOCIATES,LTD
- Practice address
- 676 N St Clair
Suite 2300
Chicago, IL 60611-2922 - Phone
- (312) 926-6000
- Fax
- (312) 276-4032
- NPI assigned
- Jun 5, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Linda D Marra, CPC
- Title
- Practice Manager
- Phone
- (312) 926-6101
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | |||
| Dermatology Physician | 207N00000X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Gastroenterology Physician | 207RG0100X | |||
| Pulmonary Disease Physician | 207RP1001X | |||
| Neurology Physician | 2084N0400X | |||
| Podiatrist | 213E00000X | |||
| Sleep Disorder Diagnostic Clinic/Center | 261QS1200X |
Addresses
Primary practice location
676 N St Clair
Suite 2300
Chicago, IL 60611-2922
Mailing address
676 N St Clair
Suite 2300
Chicago, IL 60611-2922
Phone (312) 926-6000
National Provider Directory
National Provider DirectoryLocations
Dept 4373
Carol Stream, IL 60122
676 N Saint Clair St
Ste 300
Chicago, IL 60611
Phone (312) 787-2773
676 N Saint Clair St
Ste 370
Chicago, IL 60611
Phone (312) 787-6662
Practitioners & affiliated clinicians
Practitioners 24
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Vascular Neurology Physician
- Chicago, IL
- NPI 1518950039
-
- Cardiovascular Disease Physician
- Chicago, IL
- NPI 1700879236
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1619960184
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1649263153
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1780677211
-
- Gastroenterology Physician
- Chicago, IL
- NPI 1992798417
-
- Pulmonary Disease Physician
- Chicago, IL
- NPI 1629061114
-
- Podiatrist
- Chicago, IL
- NPI 1053306076
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1063405546
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1942293451
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1851384366
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1457344970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1343001600000",
"number": "1912946120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "676 N ST CLAIR",
"address_2": "SUITE 2300",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112922",
"telephone_number": "312-926-6000",
"fax_number": "312-276-4032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "676 N ST CLAIR",
"address_2": "SUITE 2300",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112922",
"telephone_number": "312-926-6000",
"fax_number": "312-276-4032"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHICAGO LAKE SHORE MEDICAL ASSOCIATES,LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-05",
"last_updated": "2012-07-23",
"status": "A",
"authorized_official_last_name": "MARRA",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "312-926-6101",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "CPC"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Allergy & Immunology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QS1200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Sleep Disorder Diagnostic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
- Chicago Integrated Health Services
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- Chicago Lakeshore Psychotherapy LLC
- Chicago Laser Vein Institute LLC
- Chicago Lasik Center, LLC
- Chicago Lighthouse
- Chicago Lipo Laser, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.