Organization
LAKESHORE HOSPITALIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRATEEK MISHRA M.D. (PRESIDENT)
(414) 530-5082
Entity
Organization
Contact information
Practice address
850 W IRVING PARK RD, CHICAGO, IL 60613-3099
(414) 530-5082
Mailing address
30 OLIVE ST, SUITE 1, GREENFIELD, MA 01301-3318
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-118929
IL
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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