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LAKE SHORE GASTROENTEROLOGY
NPI 1932225836
Internal Medicine - Gastroenterology in Skokie, IL

Active since March 22, 2007CLIA 14D0414489 · Waiver
9701 KNOX AVE, SUITE 103, SKOKIE, IL 60076(847) 433-9840(847) 433-9842 Get Directions Write a Review

NPPES record last updated: August 27, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lake Shore Gastroenterology NPPES

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

LAKE SHORE GASTROENTEROLOGY (NPI 1932225836) is a healthcare organization registered as a gastroenterology in Skokie, Illinois and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Walter Reis Glaws, President, as its authorized official.

NPPES Registry Identity

NPI1932225836
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameLAKE SHORE GASTROENTEROLOGY
Location Address9701 KNOX AVE, SUITE 103Skokie, IL 60076-1256
Mailing Address20 Tower Ct, Suite CGurnee, IL 60031-5711 · (847) 244-2960 · Fax (847) 244-2986
Phone(847) 433-9840
Fax(847) 433-9842
Organization SubpartNo
Authorized OfficialWalter Reis GlawsPresident · (847) 244-2960
Enumeration DateMarch 22, 2007
Last NPPES UpdateAugust 27, 2007
✔ NPI 1932225836 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.

9701 KNOX AVE, Skokie, IL 60076
Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type Unspecified632680IL

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 14D0414489

Lake Shore Gastroenterology (dba) Illinois Gastroenterology Group LLC · Gurnee, IL
Active · expires Aug 31, 2026
CLIA Number14D0414489
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJonathan A. Rosenberg
Laboratory Phone(847) 244-2960
Laboratory LocationLake Shore Gastroenterology (dba) Illinois Gastroenterology Group LLC20 Tower Court, Ste F, Gurnee, IL 60031
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

DR. WOLF D PEDDINGHAUS M.D.
Internal Medicine
9701 KNOX AVE, SUITE 102
SKOKIE, IL 60076
Cook County (847) 677-1112
MR. JERRY M. ZABIN MSW
Social Worker (Clinical)
9701 KNOX AVE, 214
SKOKIE, IL 60076
Cook County (847) 677-3055
DR. MARTIN A GLOCHOWSKY M.D.
Internal Medicine
9701 KNOX AVE, 102
SKOKIE, IL 60076
Cook County (847) 676-1112
ARTHRITIS & INTERNAL MEDICINE SPECIALIST
Preferred Provider Organization
9701 KNOX AVE, STE 102
SKOKIE, IL 60076
Cook County (847) 674-7520
PETER ROONEY LTD
Urology
9701 KNOX AVE, SUITE 103
SKOKIE, IL 60076
Cook County (847) 674-5828
DR. KELLY BRUNGARDT STEIN MD
Internal Medicine
9701 KNOX AVE, STE 102
SKOKIE, IL 60076
Cook County (847) 676-1112
NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES
Anesthesiology
9701 KNOX AVE, SUITE 103
SKOKIE, IL 60076
Cook County (847) 933-6974
RUSH NORTH SHORE PAIN CENTER
Anesthesiology (Pain Medicine)
9701 KNOX AVE, SUITE 103
SKOKIE, IL 60076
Cook County (847) 933-6974

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 1932225836. It was assigned to this organization in the NPPES registry on March 22, 2007.

Where is Lake Shore Gastroenterology located?

Lake Shore Gastroenterology is located at 9701 Knox Ave Suite 103, Skokie, IL 60076. The listed phone number is (847) 433-9840.

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 14D0414489) is associated with this NPI, valid through August 31, 2026. 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 with the weekly NPPES data releases published by CMS.