Organization
LAKESIDE NEPHROLOGY, LTD.
Active
Parent organization
LAKESIDE NEPHROLOGY, LTD.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKESIDE NEPHROLOGY, LTD.
Authorized official
PATRICIA PAYNE (PRACTICE MANAGER)
(847) 581-0110
Entity
Organization
Contact information
Practice address
9332 SKOKIE BLVD, SKOKIE, IL 60077-1309
(847) 581-0110
(847) 581-1768
Mailing address
9801 WOODS DR, SKOKIE, IL 60077-1074
(847) 581-0110
(847) 581-1768
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36097354
IL
Other
Enumeration date
07/02/2008
Last updated
01/31/2024
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