Search › Illinois › 1223G0001X
Jacob Lake, DDS
NPI 1811979933 · on the registry since 2005
Practice
- Address
- 2806 W Devon Ave
Chicago, IL 60659 - Phone
- (773) 973-1100
- Fax
- (773) 973-1531
- Organisation at this address
- O Guterzon Dds Ltd
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-07-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois