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

Lakeside Nephrolgoy LTD/Prarie

Organization Specialist · NPI 1649433376

Lakeside Nephrolgoy LTD/Prarie is a Specialist in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2008.

Licensed in
IL
In the registry since
2008

Practice location Address checks out

1717 S Wabash Ave
Chicago, IL 60616-1219
Phone: (312) 913-0110
Fax: (312) 913-9154
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 36-065928 (IL)

Record details

NPI number1649433376
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLakeside Nephrology LTD/LOOP
Authorized official Sheldon Hirsch — Partner · (312) 913-0110
NPI enumeratedJuly 2, 2008
Last updated in NPPESJuly 2, 2008
Mailing address1717 S Wabash Ave, Chicago, IL 60616-1219

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