| Organization Name: | LAKEVIEW DIAGNOSTICS INC |
| NPI Number: | 1093810681 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AZAM ABBASI (PRESIDENT) |
| Mailing Address: | 708 Lavergne Ave Wilmette |
| State: | IL US |
| Postal Code: | 600912028 |
| Phone Number: | 7739100193 |
| Fax Number: | 7736372006 |
| NPI Enumeration Date: | 09/14/2006 |
| NPI Last Update Date: | 04/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471S1302X |
| License Number: | 036064756 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Sonography |
| Taxonomy Definition: | |