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

Lake Hospital System

Organization Family Medicine Physician · NPI 1326141987

Lake Hospital System provides Family Medicine Physician services in Willowick, Ohio. Licensed in Ohio. Registered with an NPI since 2006.

Licensed in
OH
In the registry since
2006
Specialties on file
3

Practice location Address checks out

29804 Lakeshore Blvd
Willowick, OH 44095 Not confirmed with CMS for 18 years — call before visiting
Phone: (440) 833-2095
Fax: (440) 833-2096
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X · Licence 35-084193 (OH)
Pediatrics Physician Taxonomy 208000000X · Licence 35-084193

Record details

NPI number1326141987
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLake Hospital System
Authorized official Robert Tracz — Chief Financial Officer · (440) 354-1051
Other names Primehealth Willowick Primary Care
NPI enumeratedSeptember 7, 2006
Last updated in NPPESApril 8, 2008
Mailing addressPo Box 714328, Columbus, OH 43271-4328

Other providers in Willowick