Organization
LAKE SHORE MEDICAR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA C PAMATMAT (PRESIDENT)
(773) 973-4811
Entity
Organization
Contact information
Practice address
2640 W TOUHY AVE, SUITE 211, CHICAGO, IL 60645-3198
(773) 973-4811
(773) 973-2614
Mailing address
2640 W TOUHY AVE, SUITE 211, CHICAGO, IL 60645-3198
(773) 973-4811
(773) 973-2614
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
001
IL
343900000X
Non-emergency Medical Transport (VAN)
Primary
001
IL
Other
Enumeration date
07/20/2007
Last updated
07/21/2022
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