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

Lake Shore Pediatrics, Ltd

Organization Pediatrics Physician · NPI 1003011628

Lake Shore Pediatrics, Ltd provides Pediatrics Physician services in Lake Forest, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

900 N Westmoreland Rd Ste 106
Lake Forest, IL 60045-1674
Phone: (847) 615-4654
Fax: (847) 615-1708
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 36065837 (IL)

Record details

NPI number1003011628
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Fondriest — Managing Partner · (847) 615-4654
NPI enumeratedJune 15, 2007
Last updated in NPPESAugust 22, 2020
Mailing address900 N Westmoreland Rd, Suite 106, Lake Forest, IL 60045-1674

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