Organization
LAKESIDE MEDICAL GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAVED NAZIR M.D. (PRESIDENT)
(773) 561-5020
Entity
Organization
Contact information
Practice address
1945 W WILSON AVE, SUITE 6119, CHICAGO, IL 60640-5255
(773) 561-5020
(773) 561-5635
Mailing address
1945 W WILSON AVE, SUITE 6119, CHICAGO, IL 60640-5255
(773) 561-5020
(773) 561-5635
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
—
IL
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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