Organization
LAKE MEDICAL CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJINDAR SINGH MD (AUTHORIZED OFFICIAL)
(847) 223-4440
Entity
Organization
Contact information
Practice address
564 BARRON BLVD, SUITE C, GRAYSLAKE, IL 60030-3355
(847) 223-4440
(847) 223-0149
Mailing address
PO BOX 263, GRAYSLAKE, IL 60030-0263
(847) 223-4440
(847) 223-0149
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036.053634
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053634
—
IL
Enumeration date
09/14/2005
Last updated
07/17/2015
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