LAKESIDE EYE CLINIC INC NPI 1871794362

NPI Information

  • NPI: 1871794362
  • Provider Name: LAKESIDE EYE CLINIC INC
  • Classification: Preferred Provider Organization - 305R00000X
  • Entity Type: Organization
  • Address: 104 S MICHIGAN AVE
    410
    CHICAGO, IL
    ZIP 60603
  • Phone: (312) 553-1818

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NPI Details

LAKESIDE EYE CLINIC INC is a preferred provider organization in Chicago, IL. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. LAKESIDE EYE CLINIC INC NPI is 1871794362. The provider is registered as an organization entity type.

The provider's business location address is:

104 S MICHIGAN AVE
410
CHICAGO, IL
ZIP 60603-902
Phone: (312) 553-1818
Fax: (312) 641-5503

The provider's authorized official is Ernesto Carrasco .
The authorized official title is President and has the following contact phone number (312) 553-1818.

The enumeration date for this NPI number is 5/30/2007 and was last updated on 8/22/2020.

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
1305R00000XPreferred Provider OrganizationILLINOISYes

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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