Lake Shore Pediatrics, Ltd
NPI 1003011628ActiveOrganization· Pediatrics· Lake Forest, IL
Pediatrics in Lake Forest, Illinois, registered in NPPES in June 2007. The authorized official on file is Diane Wheeler Fondriest, MD, Managing Partner.
Overview
| NPI | 1003011628 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 15, 2007 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | 36065837 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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