COUNTY OF LAKE (NPI# 1164446712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164446712 |
| Entity Type | Organization |
| Organization Name | COUNTY OF LAKE |
| Other Organization Name | LAKE COUNTY HEALTH DEPARTMENT AND COMMUNITY HEALTH CENTER |
| Practice Address |
3010 Grand Ave Waukegan IL 60085-2321 |
| Practice Telephone | 8473778180 |
| Practice Fax Number | 8473361517 |
| Mailing Telephone | 8473778000 |
| Mailing Fax Number | 8473602948 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-06-12 |
| Authorized Official Name | MRS. IRENE T PIERCE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8473778000 |
| Authorized Official Credential | MSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
========= | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lake County Health Department and Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477036507 | County of Lake | Community/Behavioral Health | 18736 W Peterson Rd, Libertyville, IL 60048-1064 | 2018-09-14 |
| 1093262867 | County of Lake | Clinic/Center | 15872 W 21st St, Wadsworth, IL 60083-8918 | 2016-09-08 |
| 1861857401 | County of Lake | Clinic/Center | 420 Greenwood Dr, Round Lake Park, IL 60073-3448 | 2015-12-28 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1639588254 | County of Lake | Clinic/Center | 800 High School Dr, Round Lake, IL 60073-2951 | 2014-08-07 |
| 1912333576 | County of Lake | Community/Behavioral Health | 18698 W Peterson Road, Libertyville, IL 60048 | 2013-09-16 |
| 1578861761 | County of Lake | Clinic/Center | 9345 Winchester St, Lower Lake, CA 95457-5000 | 2011-03-11 |
| 1528370277 | County of Lake | Community/Behavioral Health | 4118 Greenleaf Ct Apt 202, Park City, IL 60085-7913 | 2010-07-10 |
| 1619101292 | County of Lake | Clinic/Center | 2615 Washington Street, Waukegan, IL 60085 | 2009-05-11 |
| 1477721496 | County of Lake | Clinic/Center | 2424 Washington St, Waukegan, IL 60085-5074 | 2008-02-12 |
| Street Address |
3010 GRAND AVE |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-2321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528088895 | Georgette Bloom | Counselor | 3010 Grand Ave, Floor 1, Waukegan, IL 60085-2321 | 2006-07-20 |
| 1144837758 | Danielle Candelario | Pharmacist | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2020-09-28 |
| 1740895481 | Ashley Perez | Counselor | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2020-09-10 |
| 1528672839 | Haley Juliet Rainwater | Counselor | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2020-09-03 |
| 1477165090 | David Quintel Howery | Counselor | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2020-08-17 |
| 1558994228 | Alma Bertha Griffin | Registered Nurse | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2020-02-20 |
| 1427694413 | Shahzadhi Nyakhar | Community Health Worker | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2019-11-25 |
| 1184269623 | Jennifer Marie Winesburg | Registered Nurse | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2019-11-07 |
| 1225672157 | Tina Arnold | Counselor | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2019-11-04 |
| 1003465592 | Sindy Lorena Guerra | Counselor | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2019-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649806407 | The Josselyn Center Nfp | Clinic/Center | 415 Washington St Ste 200, Waukegan, IL 60085-5564 | 2020-03-12 |
| 1588297980 | Little City Foundation | Clinic/Center | 1301 S Lewis Ave, Waukegan, IL 60085-7814 | 2020-02-14 |
| 1811109184 | County of Lake | Clinic/Center | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2007-05-07 |
| 1700336229 | Nicasa, Nfp | Clinic/Center | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2016-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.