LAKE SHORE PLASTIC SURGERY (NPI# 1306142872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306142872 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE PLASTIC SURGERY |
| Practice Address |
60 E Delaware Pl 15th Fl Chicago IL 60611-1998 |
| Practice Telephone | 3122029000 |
| Practice Fax Number | 3122029002 |
| Mailing Telephone | 3122029000 |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-02-01 |
| Authorized Official Name | MICHAEL ALAN HORN (PRESIDENT) |
| Authorized Official Telephone | 3122029000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036092789 | IL | Other Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Lake Shore Plastic Surgery SC | 60 E Delaware, Chicago, IL 60611-1495 |
| Street Address |
60 E DELAWARE PL 15TH FL |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-1998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932136389 | Surgery Center At 900 N Michigan Ave LLC | Clinic/Center | 60 E Delaware Pl, Chicago, IL 60611-1495 | 2006-06-28 |
| 1295284412 | Plastic Surgery Chicago, LLC | Specialist | 60 E Delaware Pl, #1430, Chicago, IL 60611-1495 | 2016-09-29 |
| 1326496449 | Ram Plastic Surgery, LLC | Plastic Surgery | 60 E Delaware Pl, Suite 1430, Chicago, IL 60611-1998 | 2016-05-31 |
| 1104135466 | Mandan Farahati | Obstetrics & Gynecology | 60 E Delaware Pl, Ste 1500, Chicago, IL 60611-1998 | 2010-10-04 |
| 1720228752 | Ahmed Farag Md PC | Clinic/Center | 60 E Delaware Pl, Suite 1410, Chicago, IL 60611-6559 | 2009-03-03 |
| 1013197920 | Chicago Foot & Ankle Deformity Correction Center, LLC | Podiatrist | 60 E Delaware Pl, Suite 1480, Chicago, IL 60611-1998 | 2007-11-07 |
| 1326230434 | Michael Alan Horn | Surgery | 60 E Delaware Pl, 15th Floor, Chicago, IL 60611-1998 | 2007-08-13 |
| 1568583409 | Heather N Mccombs,dpm,llc | Podiatrist | 60 E Delaware Pl, Suite 1480, Chicago, IL 60611-1495 | 2007-04-02 |
| 1932288719 | Robert Lee Walton | Specialist | 60 E Delaware Pl, Suite 1430, Chicago, IL 60611-1495 | 2006-11-03 |
| 1659451524 | Robert A Shrifter | Anesthesiology | 60 E Delaware Pl, 15th Fl, Chicago, IL 60611-1495 | 2006-10-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| 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. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346899630 | Jeremy Gantz Morse | Specialist | 815 W Buena Ave, Chicago, IL 60613-1694 | 2019-09-09 |
| 1619539632 | Benjamin Mendoza | Specialist | 6303 W 63rd St Unit 3c, Chicago, IL 60638-7015 | 2019-06-29 |
| 1811471808 | Judith M Penn | Specialist | 8312 S Kedzie Ave, Chicago, IL 60652-3309 | 2018-09-17 |
| 1841774825 | Matthew E Huggins | Specialist | 4553 W 56th St Apt 204c, Chicago, IL 60629-5389 | 2018-09-17 |
| 1750860177 | Muhammad Asim Khan | Specialist | 60 E Delaware Pl, Chicago, Il 60611, 14th Floor Urology- Andrology Clinic, Chicago, IL 60611 | 2018-08-07 |
| 1922502657 | Shauntay Robertson | Specialist | 7342 S Richmond St, Chicago, IL 60629-3015 | 2018-03-19 |
| 1114448644 | Ageless Men's Health Holdings Inc | Specialist | 1729 N Clybourn Ave, Chicago, IL 60614-6503 | 2017-07-06 |
| 1447798871 | Andria Miller | Specialist | 840 N Western Ave, Chicago, IL 60622-4638 | 2017-02-06 |
| 1710425129 | Rtb Sc | Specialist | 5015 N. Paulina #225, Chicago, IL 60640 | 2017-02-06 |
| 1881137354 | Joy Deliverance Williamson | Specialist | 3863 W Flournoy St, Apt. 1w, Chicago, IL 60624-3617 | 2016-11-30 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.