Organization
CHICAGO LAKE SHORE MEDICAL ASSOCIATES,LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA D MARRA CPC (PRACTICE MANAGER)
(312) 926-6101
Entity
Organization
Contact information
Practice address
676 N ST CLAIR, SUITE 2300, CHICAGO, IL 60611-2922
(312) 926-6000
(312) 276-4032
Mailing address
676 N ST CLAIR, SUITE 2300, CHICAGO, IL 60611-2922
(312) 926-6000
(312) 276-4032
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2084N0400X
Neurology Physician
—
—
213E00000X
Podiatrist
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
Other
Enumeration date
06/05/2006
Last updated
07/23/2012
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