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LAKE FOREST PLACE
NPI 1063472520
Clinic/Center - Multi-Specialty in Lake Forest, IL

Active since March 27, 2006CLIA 14D2112454 · Waiver
1100 PEMBRIDGE DRIVE, LAKE FOREST, IL 60045(847) 604-6700(847) 570-3426 Get Directions Write a Review

NPPES record last updated: June 4, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lake Forest Place NPPES

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

LAKE FOREST PLACE (NPI 1063472520) is a healthcare organization registered as a multi-specialty in Lake Forest, Illinois and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through April 28, 2028 and lists Robert E Landsman, Vice President Of Finance, as its authorized official.

NPPES Registry Identity

NPI1063472520
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePRESBYTERIAN HOMES
Location Address1100 PEMBRIDGE DRIVELake Forest, IL 60045
Mailing Address3200 Grant Street, Attn Accounting DepartmentEvanston, IL 60201 · (847) 492-4871 · Fax (847) 570-3426
Phone(847) 604-6700
Fax(847) 570-3426
Organization SubpartNo
Authorized OfficialRobert E LandsmanVice President Of Finance · (847) 492-4859
Enumeration DateMarch 27, 2006
Last NPPES UpdateJune 4, 2008
✔ NPI 1063472520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedAssisted Living FacilityTaxonomy 310400000X
Also ListedSkilled Nursing FacilityTaxonomy 314000000X
1100 PEMBRIDGE DRIVE, Lake Forest, IL 60045
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Other Names 1

Doing Business AsLake Forest Place

Other Identifiers 2

Other04932281IL · Blue Cross Blue Shield Illinois
Medicare ID-Type Unspecified211076IL

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lake Forest Place is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Lake Forest Place, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Shara Frankenfeld, APN, CNS-BC
Certified Clinical Nurse Specialist (CNS)
NPI 1063955375
3200 GRANT ST
Evanston, IL 60201
(847) 570-3446
✔ PECOS✔ Accepts Medicare16 mi
Peter Jaggard, MD
Internal Medicine
NPI 1639148372
3200 GRANT ST
Evanston, IL 60201
(847) 492-4828
✔ PECOS✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2112454

Lake Forest Place · Lake Forest, IL
Active · expires Apr 28, 2028
CLIA Number14D2112454
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 29, 2026
Certificate Expiration DateApril 28, 2028
Laboratory DirectorCarol A. Van Berkel
Laboratory Phone(847) 604-6701
Laboratory LocationLake Forest Place1101 Pembridge Dr, Lake Forest, IL 60045
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Presbyterian Homes's NPI number?

The NPI number for Presbyterian Homes is 1063472520. It was assigned to this organization in the NPPES registry on March 27, 2006. The provider is doing business as Lake Forest Place.

Where is Presbyterian Homes located?

Presbyterian Homes is located at 1100 Pembridge Drive, Lake Forest, IL 60045. The listed phone number is (847) 604-6700.

What is Presbyterian Homes's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Presbyterian Homes enrolled in Medicare?

Yes. Presbyterian Homes is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Presbyterian Homes?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Presbyterian Homes, in Certified Clinical Nurse Specialist (CNS) and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Presbyterian Homes hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2112454) is associated with this NPI, valid through April 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Presbyterian Homes was last updated on June 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.