Organization
LAKEFRONT MEDICAL ASSOCIATES LLC
Active
Other names
Vanguard Medical Group - Lakefront
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG C. ARMIN (VP OF GOVT PROGRAMS, TENET)
(818) 436-2267
Entity
Organization
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 564-5102
(773) 564-5101
Mailing address
20 BURTON HILLS BLVD, NASHVILLE, TN 37215-6197
(615) 665-6000
(615) 665-6184
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1638544
BCBS - IL
IL
Enumeration date
10/09/2007
Last updated
03/18/2021
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