| Lake Forest Place | |
|
1100 Pembridge Drive Lake Forest IL 60045 | |
| (847) 604-6700 | |
| (847) 570-3426 |
| Full Name | Lake Forest Place |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1100 Pembridge Drive, Lake Forest, Illinois |
| Authorized Official Name and Position | Robert E Landsman (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 8474924859 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Forest Place 3200 Grant Street Attn Accounting Department Evanston IL 60201 Ph: (847) 492-4871 | Lake Forest Place 1100 Pembridge Drive Lake Forest IL 60045 Ph: (847) 604-6700 |
| NPI Number | 1063472520 |
|---|---|
| Provider Enumeration Date | 03/27/2006 |
| Last Update Date | 06/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063472520 | NPI | - | NPPES |
| 04932281 | Other | IL | BLUE CROSS BLUE SHIELD ILLINOIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| 310400000X | Assisted Living Facility | () | Secondary |
| 314000000X | Skilled Nursing Facility | () | Secondary |
Richard J Siebert, M.d.,s,c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 N Westmoreland Rd Ste B, Lake Forest, IL 60045 Phone: 847-234-8808 |
David Vigder MD SC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 800 N Westmoreland Rd, Suite 206, Lake Forest, IL 60045 Phone: 847-615-2227 Fax: 847-615-2228 |
Leaps and Bounds Therapy LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 455 Butler Dr, Lake Forest, IL 60045 Phone: 312-480-7433 Fax: 312-610-5655 |
Home Doctors Management Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Hunter, Lake Forest, IL 60045 Phone: 847-615-2273 Fax: 877-335-6195 |
Forward Focus Medical Care LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 990 S Waukegan Rd Ste 200, Lake Forest, IL 60045 Phone: 847-234-8100 Fax: 847-234-8199 |
Ancient Healing Omc S.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 987 Oak Knoll Dr., Lake Forest, IL 60045 Phone: 847-735-9609 Fax: 847-235-2439 |