OB/GYNE ASSOCIATES OF LAKE COUNTY, S.C. (NPI# 1497748222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497748222 |
Entity Type | Organization |
Organization Name | OB/GYNE ASSOCIATES OF LAKE COUNTY, S.C. |
Practice Address |
890 Garfield Ave Suite 200 Libertyville IL 60048-4723 |
Practice Telephone | 8475491818 |
Practice Fax Number | 8476801573 |
Mailing Telephone | 8475491818 |
Mailing Fax Number | 8476801573 |
Enumeration Date | 2005-08-26 |
Last Update Date | 2008-07-31 |
Authorized Official Name | DR. RICHARD MCCLOUD ALLEN (PHYSICIAN) |
Authorized Official Telephone | 8475491818 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
036067062 | IL | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036067062 | 05 |
Street Address |
890 GARFIELD AVE SUITE 200 |
City | LIBERTYVILLE |
State | IL |
Zip Code | 60048-4723 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720080054 | Philip N Adjei | Internal Medicine | 890 Garfield Ave, Ste 103, Libertyville, IL 60048-3100 | 2005-05-31 |
1184924961 | Ruth Mcgaha | Clinical Nurse Specialist | 890 Garfield Ave, Suite 209, Libertyville, IL 60048-4723 | 2010-10-27 |
1689824930 | Rachel E Patel | Physician Assistant | 890 Garfield Ave, Suite 200, Libertyville, IL 60069 | 2008-09-23 |
1659597730 | Illinois Internal Medicine Ltd | Internal Medicine | 890 Garfield Ave, Suite 209, Libertyville, IL 60048-4723 | 2007-04-17 |
1225169774 | Burton Miller, M.d., S.c. | Surgery | 890 Garfield Ave, 206, Libertyville, IL 60048-4723 | 2007-03-08 |
1578612677 | Libertyville Obgyn S.c. | Obstetrics & Gynecology | 890 Garfield Ave, 104, Libertyville, IL 60048-4723 | 2007-01-09 |
1831250794 | Burton Miller | Surgery | 890 Garfield Ave, 206, Libertyville, IL 60048-4723 | 2006-12-13 |
1053483909 | Gastroenterology Consultants of Libertyville Ltd | Internal Medicine | 890 Garfield Ave, Suite 103, Libertyville, IL 60048-3100 | 2006-11-15 |
1609948124 | Richard M Allen | Specialist | 890 Garfield Ave, 200, Libertyville, IL 60048-4723 | 2006-11-14 |
1225122419 | The Libertyville Surgeons, S C | Specialist | 890 Garfield Ave, Suite 203, Libertyville, IL 60048-4723 | 2006-10-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
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1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
Find all providers in zip 60048 |
Taxonomy Code | 261QM2500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Medical Specialty |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
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1063500387 | Advanced Diabetes & Endocrince Center, P.C. | Clinic/Center | 755 S. Milwaukee Ave, Suite 186, Libertyville, IL 60048 | 2006-10-11 |
1487073508 | Combined Care Center P.C. | Clinic/Center | 283 Peterson Rd, Libertyville, IL 60048-1005 | 2014-04-16 |
1619156361 | Affinity Chiropractic Center Sc | Clinic/Center | 736 Florsheim Dr, Ste. 12, Libertyville, IL 60048-3704 | 2007-10-30 |
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1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
1215598891 | Vero Clinics | Clinic/Center | 1192 E Pershing Rd, Decatur, IL 62526-4753 | 2019-06-25 |
1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
1033699467 | Healthpointe Medical Center Sc | Clinic/Center | 530 Fullerton Rd Ste B, Swansea, IL 62226-2970 | 2018-08-15 |
1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
1447764014 | Dr Courtney Drendel Inc | Clinic/Center | 515 Hamilton St # 100, Geneva, IL 60134-2138 | 2017-11-19 |
1699206599 | David M Conner M.d. | Clinic/Center | 9 Executive Woods Ct Ste 2, Swansea, IL 62226-2016 | 2017-03-22 |
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City | LIBERTYVILLE |
Zip Code | 60048 |
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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.