Organization
LAKE SHORE FOOT & ANKLE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE R STEIN DPM (OWNER)
(847) 433-4441
Entity
Organization
Contact information
Practice address
767 PARK AVE W, SUITE 130, HIGHLAND PARK, IL 60035-2400
(847) 432-6400
Mailing address
2623 N HALSTED ST, CHICAGO, IL 60614-2393
(773) 477-3668
(773) 871-1244
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004996
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004996
—
IL
Enumeration date
10/21/2008
Last updated
04/30/2015
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