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LAKESIDE MEDICAL GROUP LTD
NPI 1790809804
Internal Medicine - Adolescent Medicine in Chicago, IL

Active since March 16, 2007
1945 W WILSON AVE, SUITE 6119, CHICAGO, IL 60640(773) 561-5020(773) 561-5635 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lakeside Medical Group Ltd NPPES

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

LAKESIDE MEDICAL GROUP LTD (NPI 1790809804) is a healthcare organization registered as an adolescent medicine in Chicago, Illinois and active in the NPI registry since March 2007. The organization lists Javed Nazir, President, as its authorized official.

NPPES Registry Identity

NPI1790809804
Entity TypeOrganization
Primary Taxonomy207RA0000X
Legal Business NameLAKESIDE MEDICAL GROUP LTD
Location Address1945 W WILSON AVE, SUITE 6119Chicago, IL 60640-5255
Mailing Address1945 W Wilson Ave, Suite 6119Chicago, IL 60640-5255 · (773) 561-5020 · Fax (773) 561-5635
Phone(773) 561-5020
Fax(773) 561-5635
Organization SubpartNo
Authorized OfficialJaved NazirPresident · (773) 561-5020
Enumeration DateMarch 16, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1790809804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0000X
Definition
An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
1945 W WILSON AVE, Chicago, IL 60640
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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.

JESSICA GRACE TATSUI
Occupational Therapist (Pediatrics)
1945 W WILSON AVE
CHICAGO, IL 60640
Cook County (773) 782-2773
MARGARET T SMITH GAUTHIER P.T.
Physical Therapist (Neurology)
1945 W WILSON AVE, SU. 100
CHICAGO, IL 60640
Cook County (312) 238-3114
MS. JESSICA ANNE GOULD LCSW
Social Worker (Clinical)
1945 W WILSON AVE
CHICAGO, IL 60640
Cook County (312) 344-3879
MARGARET MARY BOLIN LCPC, CADC
Counselor (Professional)
1945 W WILSON AVE, # 6115
CHICAGO, IL 60640
Cook County (773) 307-3592
DR. MARINA VIDOVIC M.D.
Specialist
1945 W WILSON AVE, 4TH FLOOR
CHICAGO, IL 60640
Cook County (773) 769-4600
NANETTE KOTZ-JOOB N.P.
Nurse Practitioner (Pediatrics)
1945 W WILSON AVE
CHICAGO, IL 60640
Cook County (773) 736-6220
WELL INTEGRATIVE FAMILY MEDICINE, INC.
Family Medicine
1945 W WILSON AVE, 6106
CHICAGO, IL 60640
Cook County (773) 784-7000
ROSSANA SIERRA-SWIECH LCPC
Counselor (Professional)
1945 W WILSON AVE, SUITE 6117
CHICAGO, IL 60640
Cook County (773) 633-0593

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 Lakeside Medical Group Ltd's NPI number?

The NPI number for Lakeside Medical Group Ltd is 1790809804. It was assigned to this organization in the NPPES registry on March 16, 2007.

Where is Lakeside Medical Group Ltd located?

Lakeside Medical Group Ltd is located at 1945 W Wilson Ave Suite 6119, Chicago, IL 60640. The listed phone number is (773) 561-5020.

What is Lakeside Medical Group Ltd's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Adolescent Medicine, with taxonomy code 207RA0000X.

When was this NPI record last updated?

The NPPES record for Lakeside Medical Group Ltd was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.