Provider Demographics
NPI:1275571952
Name:LAKE COOK ORTHOPEDIC ASSOCIATES
Entity Type:Organization
Organization Name:LAKE COOK ORTHOPEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:G
Authorized Official - Last Name:LOCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-381-0388
Mailing Address - Street 1:27401 W HIGHWAY 22
Mailing Address - Street 2:SUITE 125
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5999
Mailing Address - Country:US
Mailing Address - Phone:847-381-0388
Mailing Address - Fax:847-381-0811
Practice Address - Street 1:27401 W HIGHWAY 22
Practice Address - Street 2:SUITE 125
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5999
Practice Address - Country:US
Practice Address - Phone:847-381-0388
Practice Address - Fax:847-381-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Not Answered207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01617254OtherBLUE SHIELD
IL01617254OtherBLUE SHIELD