Lake Street Family Medicine, Llc in Addison - Family Medicine
Lake Street Family Medicine, Llc - NPI 1639204613
Lake Street Family Medicine, Llc is a Family Medicine in Addison, Illinois. Lake Street Family Medicine, Llc practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Lake Street Family Medicine, Llc is 1639204613. The last update date is 2012-12-11.
Lake Street Family Medicine, Llc's current location address is 220 E Lake St, Addison, Illinois. You can contact this provider via phone number 6305160434 and fax number 6305160419. The mailing address for Lake Street Family Medicine, Llc is 220 E Lake St, Addison, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Street Family Medicine, Llc |
|---|---|
| Address | 220 E Lake St, Addison, Illinois |
| Phone Number | 6305160434 |
| Fax Number | 6305160419 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN |
|---|---|
| Authorized Official Name | Koecher Brian |
| Credentials | D.O. |
| Telephone Number | 6305160434 |
NPI Number Detail
| NPI Number | 1639204613 |
|---|---|
| Provider Enumeration Date | 2007-02-22 |
| Last Updated Date | 2012-12-11 |
Provider Mailing Address Detail
| Address | 220 E Lake St |
|---|---|
| City | Addison |
| State | Illinois (IL) |
| Post Code | 601012887 |
| Phone Number | 6305160434 |
| Fax Number | 6305160419 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
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Definition: 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 i |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Lake Street Family Medicine, Llc by the Centers for Medicare & Medicaid Services?
The Lake Street Family Medicine, Llc has been issued the NPI (National Provider Identifier) 1639204613, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Lake Street Family Medicine, Llc?
The Lake Street Family Medicine, Llc is physically situated at 220 E Lake St, in the city of Addison, state of IL, with the postal code 601012887.
What is Lake Street Family Medicine, Llc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Lake Street Family Medicine, Llc is Family Medicine, and the corresponding taxonomy classification code for this specialized field is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1639204613 to Lake Street Family Medicine, Llc?
The Centers for Medicare & Medicaid Services originally issued the 1639204613 to Lake Street Family Medicine, Llc on 2007-02-22.
As of what date were the details related to Lake Street Family Medicine, Llc most recently updated or revised?
The information pertaining to Lake Street Family Medicine, Llc, including its address, specialty, and other relevant details, was last updated or revised on 2012-12-11.
NPI Number: 1124025044
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