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LAKEFRONT MEDICAL ASSOCIATES LLC NPI 1144418633


NPI Information

NPI: 1144418633
Provider Name: LAKEFRONT MEDICAL ASSOCIATES LLC

Doing Business As: VANGUARD MEDICAL GROUP - LAKEFRONT

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 14D2017169

Address:
4646 N MARINE DR
CHICAGO, IL
ZIP 60640
Phone: (773) 564-5102
Get Directions

LAKEFRONT MEDICAL ASSOCIATES LLC is an internal medicine in Chicago, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. LAKEFRONT MEDICAL ASSOCIATES LLC NPI is 1144418633. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Vanguard Medical Group - Lakefront.

The provider's business location address is:

4646 N MARINE DR
CHICAGO, IL
ZIP 60640-759
Phone: (773) 564-5102
Fax: (773) 564-5101

The provider's authorized official is Craig C. Armin .
The authorized official title is Vp Of Govt Programs, Tenet and has the following contact phone number (818) 436-2267.

The CLIA number assigned to this NPI record is 14D2017169 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/9/2007 and was last updated on 3/18/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyNo
2208800000XUrologyNo
3207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11638544OTHERILLINOISBCBS - IL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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