LAKE SHORE PEDIATRICS, LTD NPI 1003011628
Pediatrics in Lake Forest, IL
NPI Profile for LAKE SHORE PEDIATRICS, LTD
Lake Shore Pediatrics, Ltd is a pediatrician established in Lake Forest, Illinois specializing in pediatrics. The NPI number of Lake Shore Pediatrics, Ltd 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 2 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)
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.
| NPI | 1003011628 |
| Provider Name | LAKE SHORE PEDIATRICS, LTD |
| Provider Location Address | 900 N WESTMORELAND RD SUITE 106 LAKE FOREST, IL 60045 |
| Provider 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 |
Primary Taxonomy
| 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
LAKE SHORE PEDIATRICS, LTD
900 N WESTMORELAND RD
SUITE 106
LAKE FOREST, IL
ZIP 60045
Phone: (847) 615-4654
Fax: (847) 615-1708
Mailing Address
LAKE SHORE PEDIATRICS, LTD
900 N WESTMORELAND RD
SUITE 106
LAKE FOREST, IL
ZIP 60045
Phone: (847) 615-4654
Fax: (847) 615-1708
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 step by step the 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 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Lake Shore Pediatrics, Ltd is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
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.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.