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LAKE STREET FAMILY MEDICINE, LLC
NPI 1639204613
Family Medicine in Addison, IL

Active since February 22, 2007
220 E LAKE ST, SUITE 100, ADDISON, IL 60101(630) 516-0434(630) 516-0419 Get Directions Write a Review

NPPES record last updated: December 11, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Street Family Medicine, Llc NPPES

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

LAKE STREET FAMILY MEDICINE, LLC (NPI 1639204613) is a healthcare organization registered as a family medicine in Addison, Illinois and active in the NPI registry since February 2007. The organization lists Brian Koecher, Physician, as its authorized official.

NPPES Registry Identity

NPI1639204613
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKE STREET FAMILY MEDICINE, LLC
Location Address220 E LAKE ST, SUITE 100Addison, IL 60101-2887
Mailing Address220 E Lake St, Suite 100Addison, IL 60101-2887 · (630) 516-0434 · Fax (630) 516-0419
Phone(630) 516-0434
Fax(630) 516-0419
Organization SubpartNo
Authorized OfficialBrian KoecherPhysician · (630) 516-0434
Enumeration DateFebruary 22, 2007
Last NPPES UpdateDecember 11, 2012
✔ NPI 1639204613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
220 E LAKE ST, Addison, IL 60101
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Other Identifiers 1

Medicare ID-Type Unspecified212461IL · Medicare Group Number

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 3

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

EKTA OHRI D.O.
Family Medicine
220 E LAKE ST, SUITE 100
ADDISON, IL 60101
Dupage County (630) 516-0434
BRIAN STEVEN KOECHER D.O.
Family Medicine
220 E LAKE ST, SUITE 100
ADDISON, IL 60101
Dupage County (630) 516-0434
GOOD SAMARITAN HOME HEALTH SERVICES, INC.
Home Health
220 E LAKE ST, SUITE 103
ADDISON, IL 60101
Dupage County (630) 833-0141

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 Street Family Medicine, LLC's NPI number?

The NPI number for Lake Street Family Medicine, LLC is 1639204613. It was assigned to this organization in the NPPES registry on February 22, 2007.

Where is Lake Street Family Medicine, LLC located?

Lake Street Family Medicine, LLC is located at 220 E Lake St Suite 100, Addison, IL 60101. The listed phone number is (630) 516-0434.

What is Lake Street Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Lake Street Family Medicine, LLC was last updated on December 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.