LAKE SHORE GASTROENTEROLOGY NPI 1932225836

NPI Information

LAKE SHORE GASTROENTEROLOGY is a gastroenterology internal medicine in Skokie, IL. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. LAKE SHORE GASTROENTEROLOGY NPI is 1932225836. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9701 KNOX AVE
SUITE 103
SKOKIE, IL
ZIP 60076-256
Phone: (847) 433-9840
Fax: (847) 433-9842

The provider's authorized official is Walter Reis Glaws .
The authorized official title is President and has the following contact phone number (847) 244-2960.

The CLIA number assigned to this NPI record is 14D0414489 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/22/2007 and was last updated on 8/27/2007.

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:

Other Identifiers

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.