| Lakeshore Gastroenterology And Liver Disease Institute S.c. | |
|
1 Erie Court Suite 3100 Oak Park IL 60614-8542 | |
| (708) 763-8248 | |
| (708) 383-7875 |
| Full Name | Lakeshore Gastroenterology And Liver Disease Institute S.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Erie Court, Oak Park, Illinois |
| Authorized Official Name and Position | Kamran Heydarpour (OWNER) |
| Authorized Official Contact | 7087638248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Gastroenterology And Liver Disease Institute S.c. Po Box 14905 Chicago IL 60614-8542 Ph: (708) 763-8248 | Lakeshore Gastroenterology And Liver Disease Institute S.c. 1 Erie Court Suite 3100 Oak Park IL 60614-8542 Ph: (708) 763-8248 |
| NPI Number | 1528237765 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 11/26/2014 |
| Medicare PECOS PAC ID | 3678564697 |
|---|---|
| Medicare Enrollment ID | O20040519000995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528237765 | NPI | - | NPPES |
| 036091055 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 336-052655 (Illinois) | Primary |
| Provider Name | Kamran Heydarpour |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093764193 PECOS PAC ID: 4981691078 Enrollment ID: I20040521000215 |
| Provider Name | Michael J Goldberg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134159064 PECOS PAC ID: 5092793083 Enrollment ID: I20040707001211 |
| Provider Name | Kenneth I Oriordan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912075649 PECOS PAC ID: 3577586239 Enrollment ID: I20060112000077 |
| Provider Name | Mani Mahdavian |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992873624 PECOS PAC ID: 3072536309 Enrollment ID: I20060112000291 |
| Provider Name | Jim Zb Lu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073590337 PECOS PAC ID: 4981505211 Enrollment ID: I20120727000410 |
| Provider Name | Igor Naryzhny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679701239 PECOS PAC ID: 2668629577 Enrollment ID: I20120829000105 |
| Provider Name | Ashish K Arora |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336157171 PECOS PAC ID: 7810137684 Enrollment ID: I20130628000484 |
| Provider Name | Shiwen Song |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538396726 PECOS PAC ID: 2466646278 Enrollment ID: I20140603002445 |
| Provider Name | Hina A Omar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972846871 PECOS PAC ID: 2264736057 Enrollment ID: I20160812001164 |
James Lo M.d., Mary Lo M.d. S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1140 W Lake St, Suite 402, Oak Park, IL 60301 Phone: 708-848-0330 | |
Diamond Gastroenterology Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1010 Lake St Ste 424, Oak Park, IL 60301 Phone: 708-613-4417 | |
Maria Slobodian Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Erie Ct, Suite#7040, Oak Park, IL 60302 Phone: 708-848-5410 Fax: 708-848-6539 | |
Anarkali Internists Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 N Marion St, Oak Park, IL 60302 Phone: 773-354-7041 | |
Pcc Community Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14 W Lake St, Oak Park, IL 60302 Phone: 708-383-0113 Fax: 708-383-9911 | |
Midwest Gi And Hepatology, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 S Maple Ave, Suite 2600, Oak Park, IL 60304 Phone: 708-290-1010 | |
Pedios, Ltd. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 Chicago Ave, Oak Park, IL 60302 Phone: 708-383-8070 Fax: 708-383-0811 |