LAKE SHORE SURGICAL ASSOCIATES, LTD. (NPI# 1396927398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396927398 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE SURGICAL ASSOCIATES, LTD. |
| Practice Address |
111 N Wabash Ave Ste 1709 Chicago IL 60602-2989 |
| Mailing Address |
Po Box 1460 Highland Park IL 60035-7460 |
| Practice Telephone | 3126411150 |
| Practice Fax Number | 3123320299 |
| Mailing Telephone | 3126411150 |
| Mailing Fax Number | 3123320299 |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |
| Authorized Official Name | DR. LAWRENCE MARK KRAUSE (PRESIDENT) |
| Authorized Official Telephone | 3126411150 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036060787 | IL | Other Service Providers |
| Street Address |
111 N WABASH AVE STE 1709 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60602-2989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437182599 | Shapiro Surgical Associates | Specialist | 111 N Wabash Ave Ste 1709, Chicago, IL 60602-2989 | 2006-07-09 |
| 1578613527 | Lawrence Mark Krause | Surgery | 111 N Wabash Ave Ste 1709, Chicago, IL 60602-2989 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710539705 | Biyang Wang | Social Worker | 9 W Washington St, Chicago, IL 60602 | 2019-07-10 |
| 1538724349 | Megan Asta Sarasek | Social Worker | 134 N Lasalle Street, Suite 400, Chicago, IL 60602 | 2019-05-07 |
| 1659850691 | Sara Chen | Dentist | 105 West Madison, 3rd Floor, Chicago, IL 60602 | 2018-08-10 |
| 1942795059 | Pratiti Rajeshkumar Gandhi | Dentist | 33 N Dearborn St Ste 2400, Chicago, IL 60602 | 2018-06-30 |
| 1154833994 | Ywca Metropolitan Chicago | Counselor | 1 North Lasalle Street, Suite 1150, Chicago, IL 60602 | 2017-11-02 |
| 1013434620 | Michelle Malters | Counselor | 30 N Michigan Ave Ste 1909, Chicago, IL 60602 | 2017-08-24 |
| 1740729474 | Jd Manikowski, D.d.s., LLC | Health Maintenance Organization | 30 N. Michigan Ave #1520, Chicago, IL 60602 | 2017-02-14 |
| 1568909943 | Pratiksha Agrawal | Dentist | 105 W Madison St Fl 3, Chicago, IL 60602 | 2017-01-24 |
| 1790221521 | Anastasia Scangas | Social Worker | 30 N Michigan Ave Ste 826, Chicago, IL 60602 | 2017-01-18 |
| 1194269837 | Jenna Peterson | Psychologist | 111 N Wabash Ave Ste 822, Chicago, IL 60602 | 2016-12-15 |
| Find all providers in zip 60602 | ||||
| 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.