LAKESIDE NEPHROLGOY LTD/PRARIE
NPI 1649433376
Specialist in Chicago, IL
NPI Status: Active since July 02, 2008
Contact Information
1717 S WABASH AVE
CHICAGO, IL
ZIP 60616
Phone: (312) 913-0110
Fax: (312) 913-9154
- Organization
- Specialist
- CLIA Number: 14D0950306
- CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
- CLIA Exp. Date: 08-20-2026
About LAKESIDE NEPHROLGOY LTD/PRARIE
This page provides the complete NPI Profile along with additional information for Lakeside Nephrolgoy Ltd/prarie, a provider established in Chicago, Illinois operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1649433376 assigned on July 2008. The practitioner's primary taxonomy code is 174400000X with license number 36-065928 (IL). The provider is registered as an organization and their NPI record was last updated 17 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 Mr. Sheldon Hirsch Md (Partner)
- NPI
- 1649433376
- Provider Name
- LAKESIDE NEPHROLGOY LTD/PRARIE
- Entity Type
- Organization
- Location Address
- 1717 S WABASH AVE CHICAGO, IL 60616
- Location Phone
- (312) 913-0110
- Location Fax
- (312) 913-9154
- Mailing Address
- 1717 S WABASH AVE CHICAGO, IL 60616
- Mailing Phone
- (312) 913-0110
- Mailing Fax
- (312) 913-9154
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 07-02-2008
- Last Update Date
- 07-02-2008
- Code Navigator
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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- 36-065928
- License State
- IL
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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:
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 |
|---|---|---|---|
| A14008 | MEDICARE UPIN (02) | 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
- 14D0950306
- Facility Type
- End Stage Renal Disease Dialysis Facility
- Certificate Effective Date
- August 21, 2024
- Certificate Expiration Date
- August 20, 2026
- Laboratory Director
- SHELDON HIRSCH
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Lakeside Nephrolgoy Ltd/prarie in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 | 6 | 4 | 9 | 4 | 3 | 3 | 3 | 7 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 8 | 9 | 8 | 3 | 6 | 3 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 8 + 9 + 8 + 3 + 6 + 3 + 1 + 4 + 24 = 74 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 74 = 6 | 6 | ||||||||
The NPI number 1649433376 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 provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1700991551 | DIALYSIS CENTERS OF AMERICA - ILLINOIS, INC. Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 1717 S WABASH AVE CHICAGO, IL 60616 (312) 913-0000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1649433376, enumerated in the NPI registry as an "organization" on July 02, 2008
The provider is located at 1717 S Wabash Ave Chicago, Il 60616 and the phone number is (312) 913-0110
This medical organization specializes in Specialist with taxonomy code 174400000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 14D0950306 for a "end stage renal disease dialysis facility" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on July 02, 2008. 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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