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LAKE SHORE PEDIATRICS, LTD
NPI 1003011628
Pediatrics in Lake Forest, IL

Active since June 15, 2007
900 N WESTMORELAND RD, SUITE 106, LAKE FOREST, IL 60045(847) 615-4654(847) 615-1708 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lake Shore Pediatrics, Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SHORE PEDIATRICS, LTD (NPI 1003011628) is a healthcare organization registered as a pediatrics in Lake Forest, Illinois and active in the NPI registry since June 2007. The organization lists Diane Wheeler Fondriest, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1003011628
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameLAKE SHORE PEDIATRICS, LTD
Location Address900 N WESTMORELAND RD, SUITE 106Lake Forest, IL 60045-1674
Mailing Address900 N Westmoreland Rd, Suite 106Lake Forest, IL 60045-1674 · (847) 615-4654 · Fax (847) 615-1708
Phone(847) 615-4654
Fax(847) 615-1708
Organization SubpartNo
Authorized OfficialDiane Wheeler FondriestManaging Partner · (847) 615-4654
Enumeration DateJune 15, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1003011628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 36065837
Definition

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.

900 N WESTMORELAND RD, Lake Forest, IL 60045
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TANNER L COLEGROVE M.D.
Obstetrics & Gynecology
900 N WESTMORELAND RD, SUITE # 207
LAKE FOREST, IL 60045
Lake County (847) 234-9110
MELISSA HILB CPNP
Nurse Practitioner (Pediatrics)
900 N WESTMORELAND RD, SUITE 110
LAKE FOREST, IL 60045
Lake County (847) 295-1220
NORTH SHORE RHEUMATOLOGY
Internal Medicine (Rheumatology)
900 N WESTMORELAND RD, SUITE 222
LAKE FOREST, IL 60045
Lake County (847) 234-6121
DR. DENISE VERGES MD
Internal Medicine (Rheumatology)
900 N WESTMORELAND RD, SUITE 222
LAKE FOREST, IL 60045
Lake County (847) 234-6121
NORTHWESTERN MEDICAL FACULTY FOUNDATION
Optometrist
900 N WESTMORELAND RD, LOWER LEVEL 88
LAKE FOREST, IL 60045
Lake County (847) 295-0001
JHAN CARLO FONTANILLA DPT
Physical Therapist
900 N WESTMORELAND RD
LAKE FOREST, IL 60045
Lake County (847) 535-6418
DR. REBECCA E JACOBSON MD
Obstetrics & Gynecology
900 N WESTMORELAND RD, STE 228
LAKE FOREST, IL 60045
Lake County (847) 234-3860
DR. BRADLEY E RUFF M.D.,
Ophthalmology
900 N WESTMORELAND RD, LL84
LAKE FOREST, IL 60045
Lake County (847) 295-0001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Shore Pediatrics, Ltd's NPI number?

The NPI number for Lake Shore Pediatrics, Ltd is 1003011628. It was assigned to this organization in the NPPES registry on June 15, 2007.

Where is Lake Shore Pediatrics, Ltd located?

Lake Shore Pediatrics, Ltd is located at 900 N Westmoreland Rd Suite 106, Lake Forest, IL 60045. The listed phone number is (847) 615-4654.

What is Lake Shore Pediatrics, Ltd's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Lake Shore Pediatrics, Ltd was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.