# LAKE FOREST CARDIOLOGY LLC

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

## Provider details

- **NPI number:** 1922342245
- **Authorized official:** DR. KRISHNASWAMI SRIRAM MD (MEMBER)
- **Authorized official phone:** (847) 615-2273

## Contact information

- **Practice address:** 611 HUNTER LN, LAKE FOREST, IL 60045-4905
- **Practice address phone:** (847) 615-2273
- **Mailing address:** 611 HUNTER LN, LAKE FOREST, IL 60045-4905
- **Mailing address phone:** (847) 615-2273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | NULL | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | — | — |

## Other

- **Enumeration date:** 11/27/2012
- **Last updated:** 04/05/2013