LAKE SHORE PATHOLOGISTS SC
NPI 1689673055
Pathology - Anatomic Pathology & Clinical Pathology in Waukegan, IL

Q: What is Lake Shore Pathologists Sc's NPI number?

The NPI number for Lake Shore Pathologists Sc is 1689673055. It was assigned to this organization in the NPPES registry on July 19, 2005.

Q: What is Lake Shore Pathologists Sc's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Active since July 19, 2005

1324 N SHERIDAN RD, VISTA MEDICAL CENTER EAST, WAUKEGAN, IL 60085(847) 360-3000 Get Directions Write a Review

NPPES record last updated: November 27, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Lake Shore Pathologists Sc NPPES

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

LAKE SHORE PATHOLOGISTS SC (NPI 1689673055) is a healthcare organization registered as an anatomic pathology & clinical pathology in Waukegan, Illinois and active in the NPI registry since July 2005. The organization lists Himani D. Dalia, Chair, as its authorized official.

NPPES Registry Identity

NPI1689673055

Entity TypeOrganization

Primary Taxonomy207ZP0102X

Legal Business NameLAKE SHORE PATHOLOGISTS SC

Location Address1324 N SHERIDAN RD, VISTA MEDICAL CENTER EASTWaukegan, IL 60085-2161

Mailing Address520 E. 22nd StreetLombard, IL 60148 · (630) 874-2542

Phone(847) 360-3000

Organization SubpartNo

Authorized OfficialHimani D. DaliaChair · (847) 360-3000

Enumeration DateJuly 19, 2005

Last NPPES UpdateNovember 27, 2007

✔ NPI 1689673055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ZP0102X

Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

1324 N SHERIDAN RD, Waukegan, IL 60085

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Other Identifiers 2

Medicare PINDB7421IL

Medicare PIN209177IL

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

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 Shore Pathologists Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Lake Shore Pathologists Sc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Srinidhi Musunuri, M.D.

Pathology

NPI 1780678920

801 S MILWAUKEE AVE
Libertyville, IL 60048

(847) 990-5149

✔ PECOS✔ Accepts Medicare8.7 mi

Kimko Suzue, M.D.

Pathology

NPI 1629233408

1501 S CALIFORNIA AVE
Chicago, IL 60608

(773) 257-6725

✔ PECOS✔ Accepts Medicare36 mi

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

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 Pathologists Sc's NPI number?

The NPI number for Lake Shore Pathologists Sc is 1689673055. It was assigned to this organization in the NPPES registry on July 19, 2005.

Where is Lake Shore Pathologists Sc located?

Lake Shore Pathologists Sc is located at 1324 N Sheridan Rd Vista Medical Center East, Waukegan, IL 60085. The listed phone number is (847) 360-3000.

What is Lake Shore Pathologists Sc's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Lake Shore Pathologists Sc enrolled in Medicare?

Yes. Lake Shore Pathologists Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Shore Pathologists Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Pathology, reassign their Medicare billing to Lake Shore Pathologists Sc. 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lake Shore Pathologists Sc was last updated on November 27, 2007. 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.