Dr Eden Louise Pappo Lake, MD is a medicare enrolled "Dermatology" physician in La Grange Park, Illinois. She went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 2013 and has 11 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Endeavor Health Medical Group and her current practice location is
321 N La Grange Rd, La Grange Park, Illinois. You can reach out to her office (for appointments etc.) via phone at
(708) 485-1271.
Dr Eden Louise Pappo Lake is licensed to practice in Illinois (license number 036.143392) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1578904892.
Physician's Profile
Full Name | Dr Eden Louise Pappo Lake |
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Gender | Female |
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Speciality | Dermatology |
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Experience | 11 Years |
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Location | 321 N La Grange Rd, La Grange Park, Illinois |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Eden Louise Pappo Lake attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 2013
NPI Data:
- NPI Number: 1578904892
- Provider Enumeration Date: 07/15/2013
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 1153622238
- Enrollment ID: I20170831002748
Medical Identifiers
Medical identifiers for Dr Eden Louise Pappo Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578904892 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 125062828 (Illinois) | Secondary |
207N00000X | Dermatology | 036.143392 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Endeavor Health Medical Group | 2163334699 | 2710 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Eden Louise Pappo Lake allows following entities to bill medicare on her behalf.
Entity Name | Northshore University Healthsystem Faculty Practice Associates |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Eden Louise Pappo Lake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Eden Louise Pappo Lake, MD 321 N La Grange Rd, La Grange Park, IL 60526-5622 Ph: (708) 485-1271 | Dr Eden Louise Pappo Lake, MD 321 N La Grange Rd, La Grange Park, IL 60526-5622 Ph: (708) 485-1271 |
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