OrganizationActive
Lakeshore Physical Therapy, LLC
NPI 1629363064 · Physical Therapy Clinic/Center · Libertyville, IL
Provider details
- NPI number
- 1629363064
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Lake County Neurosurgery, LLC
- Organization subpart
- Yes
- Authorized official
- Jonathan Citow, Owner(847) 362-1848
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
712 S Milwaukee Ave
Lower Level
Libertyville, IL 60048-3279
Phone: (847) 362-1848
Fax: (847) 362-3351
Street-level locationGet directions
Mailing address
712 S Milwaukee Ave
Libertyville, IL 60048-3279
Registry dates
- Enumerated
- 2011-06-14
- Last updated
- 2011-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.