MEDICARE: LAKE MI MOBILE DOCTORS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1437106465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKE MI MOBILE DOCTORS, P.C.

Provider Business Mailing Address
First Line	:	3319 N ELSTON AVE
Second Line	:	SUITE 200
City	:	CHICAGO
State	:	IL
Zip	:	60618-5811
Country	:	US
Telephone Number	:	773-751-7200
Fax Number	:	773-583-4401

Provider Business Practice Location Address
First Line	:	3319 N ELSTON AVE
Second Line	:	SUITE 100
City	:	CHICAGO
State	:	IL
Zip	:	60618-5811
Country	:	US
Telephone Number	:	773-751-7200
Fax Number	:	773-583-4401

Authorized Official
Title or Position	:	DIRECTOR, QUALITY ASSURANCE
Name	:	MR. TYSYN CONTRERAS
Credential	:
Telephone Number	:	312-939-5090

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	10/19/2012

Similar Medicare Providers

1962443739 — BANIO P KOROMA MD
Practice Location Address:

3319 N ELSTON AVE , SUITE 100
CHICAGO, IL
60618-5811

Practice Phone: 773-751-7200
Practice Fax: 773-583-4295

1841218740 — IN HOME DIAGNOSTICS, LLC
Practice Location Address:

3319 N. ELSTON AVE. , SUITE 116
CHICAGO, IL
60618-5811

Practice Phone: 773-751-7325
Practice Fax: 773-583-4401

1225045651 — DR. DONNA JEAN HAYES DPM
Practice Location Address:

3319 N ELSTON AVE , SUITE #100
CHICAGO, IL
60618-5811

Practice Phone: 773-751-7200
Practice Fax: 773-583-4295

1578670428 — EVA MADELYN CONTY-CUEVAS
Practice Location Address:

3319 N ELSTON AVE , SUITE #100
CHICAGO, IL
60618-5811

Practice Phone: 773-751-7200
Practice Fax: 773-583-4295

1861503468 — DR. JAMES REX MILLER III M.D
Practice Location Address:

3319 N ELSTON AVE , SUITE 100
CHICAGO, IL
60618-5811

Practice Phone: 773-751-7200
Practice Fax: 773-583-4295

1992870281 — LAKE MI MOBILE DOCTORS, P.C.
Practice Location Address:

3319 N ELSTON AVE , SUITE 100
CHICAGO, IL
60618-5811

Practice Phone: 773-751-7200
Practice Fax: 773-583-4401

Directions to “LAKE MI MOBILE DOCTORS, P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.