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Katrina Lake MD LLC

Multi-Specialty Clinic/Center in Country Club Hills, IL · enumerated 2020 · authorized official Katrina Lake, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1013536663

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Registry record

Entity type Organization (Type 2)
Legal business name Katrina Lake MD LLC
Other name <Unavail>
Practice address 18503 Bellamy Rd, Country Club Hills, IL, 60478
Phone (708) 365-8343
Enumeration date Apr 14, 2020
Last updated in NPPES May 1, 2020

Taxonomy & classification

261QM1300X Multi-Specialty Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Katrina Lake
Title Owner
Phone (708) 308-8974

Other identifiers

Identifier Type State Issuer
036141229 Medicaid IL -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Katrina Lake MD LLC?
NPPES lists Katrina Lake (Owner) as the authorized official for this organization.
What is the NPI number for Katrina Lake MD LLC?
The NPI for Katrina Lake MD LLC is 1013536663, a Type 2 (organization) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-05-01.