Individual
SAMUEL SOLOMON LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1110 W SCHICK RD, BARTLETT, IL 60103-3007
(630) 372-1100
(630) 372-6230
Mailing address
1110 W SCHICK RD, BARTLETT, IL 60103-3007
(630) 372-1100
(630) 372-6230
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
75442
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.160356
ILLINOIS MEDICAL LICENSE
IL
Enumeration date
04/04/2016
Last updated
09/11/2025
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