# PRIME HEALTHCARE GI - LAKESHORE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669291407
- **Authorized official:** CHRISTOPHER DOAN (MANAGING ASSOCIATE GENERAL COUNSEL)
- **Authorized official phone:** (310) 259-4706

## Contact information

- **Practice address:** 150 N RIVER RD STE 215, DES PLAINES, IL 60016-1297
- **Practice address phone:** (847) 787-1099
- **Mailing address:** 150 N RIVER RD STE 215, DES PLAINES, IL 60016-1297
- **Mailing address phone:** (847) 787-1099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2024
- **Last updated:** 10/08/2024