DR. EDEN LAKE, M.D.
Dermatology
Active
Individual
NPI: 1578904892
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Internal Medicine | 207R00000X | No | 125062828 (IL) |
| Dermatology | 207N00000X | Yes | 036.143392 (IL) |
Frequently Asked Questions
NPI 1578904892 is the National Provider Identifier for DR. EDEN LAKE, M.D., a Dermatology provider located in La Grange Park, IL. This NPI was enumerated on July 15, 2013.
DR. EDEN LAKE, M.D. practices at 321 N LA GRANGE RD, La Grange Park, IL 60526.
Quick Facts
- NPI
- 1578904892
- Type
- Individual
- Enumerated
- Jul 15, 2013
- Last Updated
- Mar 7, 2023
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