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

Lakeside Eye Clinic Inc

Organization Preferred Provider Organization · NPI 1871794362

Lakeside Eye Clinic Inc is a Preferred Provider Organization in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

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

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Practice location Address checks out

104 S Michigan Ave 410
Chicago, IL 60603-5902
Phone: (312) 553-1818
Fax: (312) 641-5503
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary) Taxonomy 305R00000X (IL)

Record details

NPI number1871794362
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ernesto Carrasco — President · (312) 553-1818
NPI enumeratedMay 30, 2007
Last updated in NPPESAugust 22, 2020
Mailing address104 S Michigan Ave, 410, Chicago, IL 60603-5902

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