Lake Forest Medical SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

042618006 Issued in IL

Legal business name

LAKE FOREST MEDICAL SC

Practice address

800 N Westmoreland Rd
Suite 100
Lake Forest, IL 60045-1673

Phone

(847) 604-8144

Fax

(847) 234-4682

NPI assigned

Nov 30, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Scott E Braunlich, M.D.

Title

President

Phone

(847) 604-8144

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1932183365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-604-8144",
            "fax_number": "847-234-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-604-8144",
            "fax_number": "847-234-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST MEDICAL SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "BRAUNLICH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-604-8144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "042618006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED MEDICAL CORP.",
            "identifier": "042618006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Lake Forest, IL
• Providers in Lake Forest, 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 May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.