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Organization
LAKESIDE NEPHROLOGY, LTD.
Active
Organization
LAKESIDE NEPHROLOGY, LTD.
Active
Other names
Lakeside Nephrology, Ltd.
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA PAYNE (PRACTICE MANAGER)
(847) 581-0110
Entity
Organization
Contact information
Practice address
2277 W HOWARD ST, CHICAGO, IL 60645-1922
(773) 508-0110
(773) 508-0110
Mailing address
2277 W HOWARD ST, CHICAGO, IL 60645-1922
(773) 508-0110
(773) 508-0110
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184779373
GROUP NPI
IL
Enumeration date
01/25/2007
Last updated
07/16/2025
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