Lake Shore Urology at St. Mary's – Urology Physician, NPI 1043486731

Lake Shore Urology at St. Mary's is a healthcare provider. based in Decatur, Illinois. specializing in Urology Physician. The NPI Number for Lake Shore Urology at St. Mary's is 1043486731

Main info

Organization
Name
Lake Shore Urology at St. Mary's
NPI
1043486731
Phone
(217) 464-2505
Address
1770 E LAKE SHORE DR
Authorized Official
MARK D EVARD VP OF REVENUE CYCLE
Enumeration Date
2 May 2008
Last Update Date
31 October 2024

Contacts

Secure Messaging
st_marys_decatur_toc2202619@ewd.direct.hshs.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness90
Years active:18State licenses:0Updated within 12 months

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Provider Addresses for Lake Shore Urology at St. Mary's

  • 1770, East Lake Shore Drive, Decatur, Macon County, Illinois, 62521, United States

    SUITE 202

    DECATUR, IL 625213832

    Phone: (217) 464-2505

    Fax: (217) 464-1669

    Type: Mailing

  • 3051 HOLLIS DR

    SPRINGFIELD, IL 627047450

    Phone: (217) 464-2505

    Fax: (217) 464-1669

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62521)

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Reviews

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Frequently asked questions

Can I cross-check Lake Shore Urology at St. Mary's using NPI 1043486731?
NPI 1043486731 belongs to Lake Shore Urology at St. Mary's; compare other details if you need extra assurance.
Is Lake Shore Urology at St. Mary's still an active registrant?
Lake Shore Urology at St. Mary's carries an active NPI according to the public dataset.
What clinical focus is listed for Lake Shore Urology at St. Mary's?
At a glance, Lake Shore Urology at St. Mary's is tied to Urology Physician. Clinical services aligned with this taxonomy classification.
Is Lake Shore Urology at St. Mary's located near Decatur?
Lake Shore Urology at St. Mary's currently maps to Decatur, Illinois in this extract.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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