LAKE SHORE ADULT & GERIATRIC MEDICINE, LTD
NPI 1326056276
Family Medicine in Chicago, IL
NPI Status: Active since August 04, 2006
Contact Information
150 E HURON STREET
SUITE 805
CHICAGO, IL
ZIP 60611
Phone: (312) 649-6565
Fax: (312) 649-9842
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 14D1054059
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-09-2026
About LAKE SHORE ADULT & GERIATRIC MEDICINE, LTD
This page provides the complete NPI Profile along with additional information for Lake Shore Adult & Geriatric Medicine, Ltd, a primary care provider established in Chicago, Illinois operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1326056276 assigned on August 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 036095873 (IL). The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Mark Vexelman Md (President)
- NPI
- 1326056276
- Provider Name
- LAKE SHORE ADULT & GERIATRIC MEDICINE, LTD
- Entity Type
- Organization
- Location Address
- 150 E HURON STREET SUITE 805 CHICAGO, IL 60611
- Location Phone
- (312) 649-6565
- Location Fax
- (312) 649-9842
- Mailing Address
- 150 E HURON STREET SUITE 805 CHICAGO, IL 60611
- Mailing Phone
- (312) 649-6565
- Mailing Fax
- (312) 649-9842
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-04-2006
- Last Update Date
- 04-09-2010
- Code Navigator
A primary care provider (PCP) like Lake Shore Adult & Geriatric Medicine, Ltd sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036095873
- License State
- IL
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- MyBlue Plus Bronze? 903 - POS
- MyBlue Plus Bronze? 912 - POS
- MyBlue Plus Bronze? Standard - Select Rx Copays - POS
- MyBlue Plus Gold? 909 - POS
- MyBlue Plus Gold? 910 - POS
- MyBlue Plus Gold? Standard - Rx Copays - POS
- MyBlue Plus Silver? 905 - POS
- MyBlue Plus Silver? 906 - POS
- MyBlue Plus Silver? Standard - Select Rx Copays - POS
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 with Rx Copay - HMO
- Silver 1 - HMO
- Silver 1 with Rx Copay and Adult Vision Services - HMO
- Silver 12 with first 4 free PCP or MH visits - HMO
- Silver 8 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 208984 | MEDICARE PIN (08) | IL |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D1054059
- Facility Type
- Physician Office
- Certificate Effective Date
- May 10, 2024
- Certificate Expiration Date
- May 09, 2026
- Laboratory Director
- DR. MARK VEXELMAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lake Shore Adult & Geriatric Medicine, Ltd to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LAKE SHORE ADULT & GERIATRIC MEDICINE, LTD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 2 | 6 | 0 | 5 | 6 | 2 | 7 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 4 | 6 | 0 | 5 | 12 | 2 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 4 + 6 + 0 + 5 + 1 + 2 + 2 + 1 + 4 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1326056276 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1700896750 | DR. MARK VEXELMAN MD Individual | Family Medicine | 150 E HURON STREET SUITE 805 CHICAGO, IL 60611 (312) 649-6565 |
| 1093989170 | EDWARD TUDER MD Individual | Psychiatry & Neurology (Psychiatry) | 150 E HURON STREET SUITE 1306 CHICAGO, IL 60611 (312) 943-0378 |
| 1538171590 | ELIZABETH WALZ-BUSCHER M.D Individual | Obstetrics & Gynecology | 150 E HURON STREET 825 CHICAGO, IL 60611 (312) 751-7515 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1326056276, enumerated in the NPI registry as an "organization" on August 04, 2006
The provider is located at 150 E Huron Street Suite 805 Chicago, Il 60611 and the phone number is (312) 649-6565
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Molina. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 14D1054059 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on August 04, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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