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LAKESIDE EYE GROUP S.C. NPI 1497954820


NPI Information

NPI: 1497954820
Provider Name: LAKESIDE EYE GROUP, S.C.

Former Legal Business Name: TAUB EYE CENTER, S.C

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
180 N MICHIGAN AVE
SUITE 1900
CHICAGO, IL
ZIP 60601
Phone: (312) 553-1818
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LAKESIDE EYE GROUP, S.C. is a specialist in Chicago, 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 EYE GROUP, S.C. NPI is 1497954820. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Taub Eye Center, S.c.

The provider's business location address is:

180 N MICHIGAN AVE
SUITE 1900
CHICAGO, IL
ZIP 60601-401
Phone: (312) 553-1818
Fax: (312) 641-5503

The provider's authorized official is Sanjay N Rao .
The authorized official title is Ophthalmologist and has the following contact phone number (312) 553-1818.

The enumeration date for this NPI number is 7/16/2007 and was last updated on 7/22/2013.


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
1174400000XSpecialist042007938ILLINOISYes

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
1036102488MEDICAIDILLINOIS
2369060OTHERILLINOISGROUP NUMBER FOR MEDICARE
331601613OTHERILLINOISBLUE CROSS BLUE SHIELD OF

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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