LAKESIDE NEPHROLOGY LTD. NPI 1386807006

NPI Information

  • NPI: 1386807006
  • Provider Name: LAKESIDE NEPHROLOGY, LTD.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 14D0986005
  • Address: 9332 SKOKIE BLVD
    SKOKIE, IL
    ZIP 60077
  • Phone: (847) 581-0110

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NPI Details

LAKESIDE NEPHROLOGY, LTD. is a specialist in Skokie, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LAKESIDE NEPHROLOGY, LTD. NPI is 1386807006. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9332 SKOKIE BLVD
SKOKIE, IL
ZIP 60077-309
Phone: (847) 581-0110
Fax: (847) 581-1768

The provider's authorized official is Patricia Payne .
The authorized official title is Practice Manager and has the following contact phone number (847) 581-0110.

The CLIA number assigned to this NPI record is 14D0986005 - end stage renal disease dialysis facility with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/2/2008 and was last updated on 1/31/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist36097354ILLINOISYes

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: 11/21/2025

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