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

Lake Street Family Medicine, LLC

Organization Family Medicine Physician · NPI 1639204613

Lake Street Family Medicine, LLC is a Family Medicine Physician in Addison, Illinois. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

220 E Lake St Ste 100
Addison, IL 60101-2887
Phone: (630) 516-0434
Fax: (630) 516-0419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1639204613
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brian Koecher — Physician · (630) 516-0434
NPI enumeratedFebruary 22, 2007
Last updated in NPPESDecember 11, 2012
Mailing address220 E Lake St, Suite 100, Addison, IL 60101-2887

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