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LAKE STREET FAMILY PHYSICIANS SC INC
NPI 1841363850
Family Medicine in Oak Park, IL

Active since November 16, 2006CLIA 14D0981005 · Microscopy
1010 W LAKE ST, SUITE 500, OAK PARK, IL 60301(708) 524-8600(708) 524-8147 Get Directions Write a Review

NPPES record last updated: February 12, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lake Street Family Physicians Sc Inc NPPES

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

LAKE STREET FAMILY PHYSICIANS SC INC (NPI 1841363850) is a healthcare organization registered as a family medicine in Oak Park, Illinois and active in the NPI registry since November 2006. The organization holds a CLIA Microscopy certificate valid through February 1, 2028 and lists Nancy Bell, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1841363850
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKE STREET FAMILY PHYSICIANS SC INC
Location Address1010 W LAKE ST, SUITE 500Oak Park, IL 60301
Mailing AddressPo Box 799Oak Park, IL 60303 · (708) 524-8600 · Fax (708) 524-8147
Phone(708) 524-8600
Fax(708) 524-8147
Organization SubpartNo
Authorized OfficialNancy BellPractice Manager · (708) 524-8600
Enumeration DateNovember 16, 2006
Last NPPES UpdateFebruary 12, 2013
✔ NPI 1841363850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 042618366
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.
1010 W LAKE ST, Oak Park, IL 60301
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Other Identifiers 3

Medicare PIN210292IL
Other01634822IL · Bcbs
OtherDD3406IL · Medicare Railroad

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

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 Street Family Physicians Sc Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Lake Street Family Physicians Sc Inc, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 10 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Family Practice9
Internal Medicine1

Clinicians, nearest first (10)

Eunice Chan, D.O.
Family Practice
NPI 1770847766
1010 LAKE ST SUITE 500
Oak Park, IL 60301
(708) 524-8600
✔ PECOSSame address
Deborah Manus, M.D.
Family Practice
NPI 1700921699
1010 W LAKE ST STE 500
Oak Park, IL 60301
(708) 524-8600
✔ PECOSSame address
Marian Sassetti, M.D.
Family Practice
NPI 1881739753
1010 LAKE ST SUITE 500
Oak Park, IL 60301
(708) 524-8600
✔ PECOSSame address
Kathryn Vanbuskirk, D.O.
Family Practice
NPI 1073045266
1010 LAKE ST STE 301
Oak Park, IL 60301
(708) 524-8600
✔ PECOSSame address
Matthew Hagenswiecicki, DO
Family Practice
NPI 1730747924
1010 LAKE ST STE 301
Oak Park, IL 60301
(708) 524-8600
✔ PECOS✔ Accepts MedicareSame address
Christa Harlin-Egan, MD
Family Practice
NPI 1881171122
1010 LAKE ST STE 301
Oak Park, IL 60301
(708) 524-8600
✔ PECOS✔ Accepts MedicareSame address
Paul Kungl, MD
Family Practice
NPI 1831234749
1010 LAKE ST STE 301
Oak Park, IL 60301
(708) 524-8600
✔ PECOS✔ Accepts MedicareSame address
Katherine Maietta, M.D.
Internal Medicine
NPI 1275799710
1010 LAKE ST STE 301
Oak Park, IL 60301
(708) 524-8600
✔ PECOS✔ Accepts MedicareSame address
Stephen Whitfield, MD
Family Practice
NPI 1942691613
1010 LAKE ST STE 301
Oak Park, IL 60301
(708) 524-8600
✔ PECOS✔ Accepts MedicareSame address
Allison Donovan, MD
Family Practice
NPI 1003374141
4732 N LINCOLN AVE STE 200
Chicago, IL 60625
(312) 926-3627
✔ PECOS✔ Accepts Medicare7.9 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 for Provider-Performed Microscopy Procedures (PPMP) 14D0981005

Lake Street Family Physicians · Oak Park, IL
Active · expires Feb 1, 2028
CLIA Number14D0981005
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorPaul A. Kungl MD
Laboratory Phone(708) 524-8600
Laboratory LocationLake Street Family Physicians1010 Lake Street-Suite 301, Oak Park, IL 60301
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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 Lake Street Family Physicians Sc Inc's NPI number?

The NPI number for Lake Street Family Physicians Sc Inc is 1841363850. It was assigned to this organization in the NPPES registry on November 16, 2006.

Where is Lake Street Family Physicians Sc Inc located?

Lake Street Family Physicians Sc Inc is located at 1010 W Lake St Suite 500, Oak Park, IL 60301. The listed phone number is (708) 524-8600.

What is Lake Street Family Physicians Sc Inc's specialty?

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

Is Lake Street Family Physicians Sc Inc enrolled in Medicare?

Yes. Lake Street Family Physicians Sc Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Street Family Physicians Sc Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 2 Medicare specialties reassign their Medicare billing to Lake Street Family Physicians Sc Inc. 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. The largest specialties are Family Practice (9) and Internal Medicine (1). Of these, 9 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lake Street Family Physicians Sc Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D0981005) is associated with this NPI, valid through February 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Street Family Physicians Sc Inc accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Lake Street Family Physicians Sc Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Street Family Physicians Sc Inc was last updated on February 12, 2013. 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.