Lake Shore Mental Health Services, Inc.

LBN: Lake Shore Mental Health Services
Lake Shore Mental Health Services, Inc. is an health care organization with primary practice located at 7638 S Evans Ave Ste B , Chicago IL 60619-2519. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Lake Shore Mental Health Services can be contacted via phone (728) 201-6911, or through Diggs, Annette N via phone (773) 559-0393.

Contact Information

Primary practice address
7638 S Evans Ave Ste B Chicago IL 60619-2519
Phone: (728) 201-6911
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Diggs, Annette N PMHNP-BC
Phone: (773) 559-0393

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X

Profile Details

NPI number 1417557968
LBN Legal business name Lake Shore Mental Health Services
DBA Doing business as Lake Shore Mental Health Services, Inc.
Authorized official Diggs, Annette N PMHNP-BC
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2020
Last updated Apr 6th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417557968 NPPES
Illinois MEDICAID 341763684002

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