Organization
LAKE SHORE FOOT & ANKLE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE R STEIN DPM (PRESIDENT)
(773) 477-3668
Entity
Organization
Contact information
Practice address
2623 N HALSTED ST, CHICAGO, IL 60614-2393
(773) 477-3668
(773) 871-1244
Mailing address
2623 N HALSTED ST, CHICAGO, IL 60614-2393
(773) 477-3668
(773) 871-1244
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01627920
BCBS
IL
01
—
DF0111
RAILROAD MEDICARE
IL
Enumeration date
07/28/2006
Last updated
04/30/2015
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