Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Cicero Clinic, SC

Organization Internal Medicine Physician · NPI 1336498062

Lake Cicero Clinic, SC is an Internal Medicine Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in
IL
In the registry since
2012

Practice location Address checks out

4801 W Lake St
Chicago, IL 60644-2609
Phone: (773) 378-8100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036085519 (IL)

Record details

NPI number1336498062
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gurcharan Randhawa — Owner - Physician · (773) 378-8100
Other names Lake Cicero Clinic
NPI enumeratedSeptember 10, 2012
Last updated in NPPESSeptember 10, 2012
Mailing address4801 W Lake St, Chicago, IL 60644-2609

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