Organization
LAKE SHORE SURGICAL ASSOCIATES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE MARK KRAUSE MD (PRESIDENT)
(312) 641-1150
Entity
Organization
Contact information
Practice address
111 N WABASH AVE STE 1709, CHICAGO, IL 60602-2989
(312) 641-1150
(312) 332-0299
Mailing address
PO BOX 1460, HIGHLAND PARK, IL 60035-7460
(312) 641-1150
(312) 332-0299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036060787
IL
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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