LAKE SHORE MEDICAL ASSOCIATES LTD. NPI 1093703688

NPI Information

LAKE SHORE MEDICAL ASSOCIATES, LTD. is a clinic center in Chicago, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). LAKE SHORE MEDICAL ASSOCIATES, LTD. NPI is 1093703688. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2222 W DIVISION ST STE 116
CHICAGO, IL
ZIP 60622-093
Phone: (773) 525-7720
Fax: (773) 525-9199

The provider's authorized official is Vijayalakshmi Arekapudi .
The authorized official title is President and has the following contact phone number (773) 525-7720.

The CLIA number assigned to this NPI record is 14D0424497 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/8/2005 and was last updated on 6/3/2016.

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.

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