Lake Shore Pediatrics, Ltd

NPI 1003011628 - Pediatrics - 208000000X

NPI Details
NPI 1003011628
Enumeration Date 06/15/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DIANE WHEELER DIANE
Position MANAGING PARTNER
Phone (847) 615-4654
Fax (847) 615-1708
Practice Location
900 N WESTMORELAND RD
SUITE 106
LAKE FOREST IL, 60045-1674, US
Phone (847) 615-4654
Fax (847) 615-1708
Business Location
900 N WESTMORELAND RD
SUITE 106
LAKE FOREST IL, 60045-1674, US
Phone (847) 615-4654
Fax (847) 615-1708
Toxanomy
Taxonomy Code 208000000X
License State Illinois
License Number 36065837
Remove 1003011628 NPI Number
 

According to our database, Lake Shore Pediatrics, Ltd NPI is 1003011628, taxonomy code is 208000000X and license number is 36065837, license state is located at Illinois. Lake Shore Pediatrics, Ltd physically located at 900 N Westmoreland Rd, Lake Forest IL, 60045-1674. NPI Number 1033115704 has the healthcare provider type.

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1003011628 NPI number is provided on an as is basis without warranty of any kind. 1003011628 is maintained by the National Plan & Provider Enumeration System. The contents of Lake Shore Pediatrics, Ltd are for informational purposes only.