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
2277 W HOWARD ST, CHICAGO, IL 60645-1922
(773) 508-0110
(773) 508-0074
Mailing address
2277 W HOWARD ST, CHICAGO, IL 60645-1922
(773) 508-0110
(773) 508-0074
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36-046704
IL
Other
Enumeration date
07/02/2008
Last updated
01/31/2024
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