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

Lake Shore Pediatrics, Ltd

Organization Pediatrics Physician · NPI 1003011628

Lake Shore Pediatrics, Ltd is a Pediatrics Physician in Lake Forest, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

900 N Westmoreland Rd Ste 106
Lake Forest, IL 60045-1674
Phone: (847) 615-4654
Fax: (847) 615-1708
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 36065837 (IL)

Record details

NPI number1003011628
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Fondriest — Managing Partner · (847) 615-4654
NPI enumeratedJune 15, 2007
Last updated in NPPESAugust 22, 2020
Mailing address900 N Westmoreland Rd, Suite 106, Lake Forest, IL 60045-1674

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