Lake Shore Dermatology, Ltd.
NPI 1902977937 · Dermatology Physician · Park City, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake Shore Dermatology, Ltd. is a Dermatology Physician organization in Park City, IL (NPI 1902977937).
Provider details
- NPI number
- 1902977937
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kavitha Gandhi, President(847) 680-7100
- License
- 336067198 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
Mailing address
Registry dates
- Enumerated
- 2006-11-13
- Last updated
- 2020-08-22
Frequently asked questions
- What is Lake Shore Dermatology, Ltd.'s NPI number?
- Lake Shore Dermatology, Ltd.'s National Provider Identifier (NPI) is 1902977937, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Shore Dermatology, Ltd.?
- Lake Shore Dermatology, Ltd. is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Lake Shore Dermatology, Ltd. located?
- Lake Shore Dermatology, Ltd.'s practice location on file with NPPES is 351 S. Greenleaf, Park City, IL 60085.
- What is Lake Shore Dermatology, Ltd.'s phone number?
- The practice phone number listed in the NPPES registry for Lake Shore Dermatology, Ltd. is (847) 680-7100.
- Does Lake Shore Dermatology, Ltd. accept Medicare?
- Lake Shore Dermatology, Ltd. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake Shore Dermatology, Ltd.?
- The authorized official listed on Lake Shore Dermatology, Ltd.'s NPPES record is Kavitha Gandhi, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Shore Dermatology, Ltd.'s NPI active?
- Yes — Lake Shore Dermatology, Ltd.'s NPI (1902977937) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.