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LAKE SHORE GASTROENTEROLOGY
NPI 1588780894
Internal Medicine - Gastroenterology in Evanston, IL

Active since March 21, 2007CLIA 14D2040811 · Waiver
800 AUSTIN ST, SUITE 403 WEST TOWER, EVANSTON, IL 60202(847) 491-9020(847) 491-0182 Get Directions Write a Review

NPPES record last updated: August 27, 2007. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Lake Shore Gastroenterology NPPES

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

LAKE SHORE GASTROENTEROLOGY (NPI 1588780894) is a healthcare organization registered as a gastroenterology in Evanston, Illinois and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through May 9, 2028 and lists Walter Reid Glaws, President, as its authorized official.

NPPES Registry Identity

NPI1588780894
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameLAKE SHORE GASTROENTEROLOGY
Location Address800 AUSTIN ST, SUITE 403 WEST TOWEREvanston, IL 60202-3439
Mailing Address20 Tower Ct, Suite CGurnee, IL 60031-5711 · (847) 244-2960 · Fax (847) 244-2986
Phone(847) 491-9020
Fax(847) 491-0182
Organization SubpartNo
Authorized OfficialWalter Reid GlawsPresident · (847) 244-2960
Enumeration DateMarch 21, 2007
Last NPPES UpdateAugust 27, 2007
✔ NPI 1588780894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
800 AUSTIN ST, Evanston, IL 60202
Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type Unspecified632380IL

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

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 14D2040811

Lake Shore Gastroenterology(dba) Illinois Gastroenterology Group LLC · Evanston, IL
Active · expires May 9, 2028
CLIA Number14D2040811
Laboratory TypePhysician Office
Certificate Effective DateMay 10, 2026
Certificate Expiration DateMay 9, 2028
Laboratory DirectorFred B. Rosenberg
Laboratory Phone(847) 491-9020
Laboratory LocationLake Shore Gastroenterology(dba) Illinois Gastroenterology Group LLC800 Austin Ave, Ste 403, Evanston, IL 60202
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

AJIT KUMAR KESANI M.D.
Internal Medicine (Nephrology)
800 AUSTIN ST, ST. FRANCIS PROFESSIONAL BUILDING, WEST TOWER SUITE 503
EVANSTON, IL 60202
Cook County (847) 864-5550
ENVISION MOBILE IMAGING, LLC
Clinic/Center (Radiology, Mobile)
800 AUSTIN ST
EVANSTON, IL 60202
Cook County (312) 515-0289
ALBERTO E FOSCHI MD
Internal Medicine (Cardiovascular Disease)
800 AUSTIN ST, SUITE 454 EAST TOWER
EVANSTON, IL 60202
Cook County (847) 864-4370
DR. CHARLES R GRUNER M.D.
Surgery
800 AUSTIN ST, EAST TOWER, SUITE 563
EVANSTON, IL 60202
Cook County (847) 869-0522
DR. HENRY ISAAC MEISELS M.D.
Ophthalmology
800 AUSTIN ST, SUITE 401W
EVANSTON, IL 60202
Cook County (847) 425-9400
BENJAMIN PHILLIPS
Counselor (Mental Health)
800 AUSTIN ST
EVANSTON, IL 60202
Cook County (847) 868-8664
YOUSEF DARWISH MD.PC
Specialist
800 AUSTIN ST, SUITE 163
EVANSTON, IL 60202
Cook County (847) 316-3880
VISION SURGEONS AND CONSULTANTS, LTD
Surgery
800 AUSTIN ST, EAST TOWER STE 151
EVANSTON, IL 60202
Cook County (847) 328-2300

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 Gastroenterology's NPI number?

The NPI number for Lake Shore Gastroenterology is 1588780894. It was assigned to this organization in the NPPES registry on March 21, 2007.

Where is Lake Shore Gastroenterology located?

Lake Shore Gastroenterology is located at 800 Austin St Suite 403 West Tower, Evanston, IL 60202. The listed phone number is (847) 491-9020.

What is Lake Shore Gastroenterology's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Lake Shore Gastroenterology hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2040811) is associated with this NPI, valid through May 9, 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 Lake Shore Gastroenterology was last updated on August 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.