LAKE SHORE PEDIATRICS, LTD NPI 1003011628
Pediatrics in Lake Forest, IL
About LAKE SHORE PEDIATRICS, LTD
Lake Shore Pediatrics, Ltd is a pediatrician established in Lake Forest, Illinois operating as a Pediatrics. The NPI number of this provider is 1003011628 and was assigned on June 2007. The practitioner's primary taxonomy code is 208000000X with license number 36065837 (IL). The provider is registered as an organization and their NPI record was last updated 3 years ago. Lake Shore Pediatrics, Ltd operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Diane Wheeler Fondriest Md (Managing Partner)
| NPI | 1003011628 |
| Provider Name | LAKE SHORE PEDIATRICS, LTD |
| Location Address | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 |
| Location Phone | (847) 615-4654 |
| Mailing Address | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 06-15-2007 |
| Last Update Date | 08-22-2020 |
A pediatrician like Lake Shore Pediatrics, Ltd is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc..
The CLIA number of Lake Shore Pediatrics, Ltd is 14D0412983 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Lake Shore Pediatrics, Ltd to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 208000000X |
| Classification | Pediatrics |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 36065837 |
| License State | IL |
| Taxonomy Description | A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Business Address
900 N WESTMORELAND RD
SUITE 106
LAKE FOREST, IL
ZIP 60045
Phone: (847) 615-4654
Fax: (847) 615-1708
Mailing Address
900 N WESTMORELAND RD
SUITE 106
LAKE FOREST, IL
ZIP 60045
Phone: (847) 615-4654
Fax: (847) 615-1708
Location Map
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003011628 is:
| CLIA Number | 14D0412983 |
| Facility Type | PHYSICIAN OFFICE |
| Certificate Type | Certificate of Waiver |
Group Taxonomy
193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 1 | 1 | 6 | 2 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 2 | 6 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 1 + 2 + 6 + 4 + 24 = 42 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 42 = 8 | 8 | ||||||||
The NPI number 1003011628 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1366437352 | SHERI ROSS MD Individual | Pediatrics | 900 N WESTMORELAND RD 106 LAKE FOREST, IL 60045 (847) 615-0700 |
| 1770578775 | DAVID SALTZMAN MD Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 (847) 615-0700 |
| 1144215146 | MELANIE E GOODELL MD Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 (847) 615-0700 |
| 1568457554 | DIANE ELIZABETH FONDRIEST MD Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 (847) 615-4654 |
| 1881689875 | SUSAN SHEINKOP MD Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 (847) 615-0700 |
| 1952396962 | DEBORAH GAIL GULSON MD Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 (847) 615-0700 |
| 1932199718 | RILINA GHOSH MD Individual | Pediatrics | 900 N WESTMORELAND RD STE 106 LAKE FOREST, IL 60045 (847) 615-0700 |
| 1376533166 | RILEY M MINSTER MD Individual | Pediatrics | 900 N WESTMORELAND RD STE 106 LAKE FOREST, IL 60045 (847) 615-0700 |
| 1336123884 | DR. GARY EDWARD SCHAFFEL M.D. Individual | Internal Medicine | 900 N WESTMORELAND RD SUITE 104 LAKE FOREST, IL 60045 (847) 234-8100 |
| 1649255902 | LAKE FOREST OBSTETRICS GYNECOLOGY & INFERTILITY S.C. Organization | Obstetrics & Gynecology | 900 N WESTMORELAND RD SUITE 228 LAKE FOREST, IL 60045 (847) 234-3860 |
| 1891770152 | DR. LIONEL J SCHEWITZ M.D. Individual | Obstetrics & Gynecology (Gynecology) | 900 N WESTMORELAND RD SUITE 228 LAKE FOREST, IL 60045 (847) 234-3860 |
| 1942285689 | DR. DAVID C SCHEWITZ M.D. Individual | Obstetrics & Gynecology | 900 N WESTMORELAND RD SUITE 228 LAKE FOREST, IL 60045 (847) 234-3860 |
| 1376520312 | JAMES E DEVINE PHD Individual | Psychologist (Clinical) | 900 N WESTMORELAND RD STE LL70 LAKE FOREST, IL 60045 (847) 295-0340 |
| 1235196858 | DR. MARK ALLAN BERK M.D. Individual | Dermatology | 900 N WESTMORELAND RD SUITE 222 LAKE FOREST, IL 60045 (847) 234-6121 |
| 1306883756 | DR. ALLEN I KRISSBERG M.D. Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 110 LAKE FOREST, IL 60045 (847) 295-1220 |
| 1487694097 | DR. RICHARD P. MARTINO DDS Individual | Dentist (Oral and Maxillofacial Pathology) | 900 N WESTMORELAND RD SUITE 208 LAKE FOREST, IL 60045 (847) 234-3390 |
| 1730121872 | DR. MICHAEL W TERKILDSEN M.D. Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 110 LAKE FOREST, IL 60045 (847) 295-1220 |
| 1770526220 | DR. BERNARD B PRITZKER M.D. Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 110 LAKE FOREST, IL 60045 (847) 295-1220 |
| 1215972799 | DR. GERALD LASIN MD Individual | Pediatrics | 900 N WESTMORELAND RD SUITE 110 LAKE FOREST, IL 60045 (847) 295-1220 |
| 1659316768 | DAWN RIBNEK Individual | Nurse Practitioner (Pediatrics) | 900 N WESTMORELAND RD SUITE 110 LAKE FOREST, IL 60045 (847) 295-1220 |
Frequently Asked Questions
What is LAKE SHORE PEDIATRICS, LTD NPI number?
The NPI number assigned to this healthcare provider is 1003011628, registered as an "organization" on June 15, 2007
Where is LAKE SHORE PEDIATRICS, LTD located?
The provider is located at 900 N Westmoreland Rd Suite 106 Lake Forest, Il 60045 and the phone number is (847) 615-4654
What kind of medical provider is LAKE SHORE PEDIATRICS, LTD?
This medical organization specializes in Pediatrics
What is LAKE SHORE PEDIATRICS, LTD CLIA number?
The provider's CLIA number is 14D0412983 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
How do I update my NPI information?
The NPI record of LAKE SHORE PEDIATRICS, LTD was last updated on June 15, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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