CONDELL MEDICAL CENTER (NPI# 1609813419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609813419 |
| Entity Type | Organization |
| Organization Name | CONDELL MEDICAL CENTER |
| Other Organization Name | CONDELL MED CTR GRAYS LAKE |
| Practice Address |
1170 E Belvidere Rd Grayslake IL 60030-2061 |
| Mailing Address |
900 Garfield Ave Libertyville IL 60048-3141 |
| Practice Telephone | 8472230127 |
| Mailing Telephone | 8473622905 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. ANDREW STEFO (VICE PRESIDENT OF FINANCE/CFO) |
| Authorized Official Telephone | 8479905205 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0207X |
Clinic/Center Specialization: Radiology, Mobile Mammography |
0000422 | IL | Ambulatory Health Care Facilities |
| N | 282N00000X | General Acute Care Hospital | IL | Hospitals |
| Other Name | Type Code |
|---|---|
| Condell Med Ctr Grays Lake | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235170317 | Condell Medical Center | Clinic/Center | 1435 N Hunt Club Rd, Gurnee, IL 60031-2656 | 2006-06-09 |
| 1043213911 | Condell Medical Center | General Acute Care Hospital | 801 S Milwaukee Ave, Libertyville, IL 60048-3199 | 2005-05-24 |
| Street Address |
1170 E BELVIDERE RD |
| City | GRAYSLAKE |
| State | IL |
| Zip Code | 60030-2061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417921 | William R. Storino | Podiatrist | 1170 E Belvidere Rd, Ste 202, Grayslake, IL 60030-2076 | 2005-06-16 |
| 1427589027 | Forefront Dermatology, S.c. | Dermatology | 1170 E Belvidere Rd, Suite 206, Grayslake, IL 60030 | 2017-03-24 |
| 1750826103 | Elizabeth Souza | Social Worker | 1170 E Belvidere Rd, Suite 201, Grayslake, IL 60030-2061 | 2016-12-21 |
| 1235597485 | Tina Louise Bernardi | Nurse Practitioner | 1170 E Belvidere Rd, Suite 212, Grayslake, IL 60030-2061 | 2016-02-03 |
| 1043639255 | Tina Mandelman | Nurse Practitioner | 1170 E Belvidere Rd, Suite 106, Grayslake, IL 60030-2061 | 2014-04-15 |
| 1417264698 | Thurston & Associates | Counselor | 1170 E Belvidere Rd, Suite 201, Grayslake, IL 60030-2061 | 2010-09-09 |
| 1265672729 | Irma Sharp | Social Worker | 1170 E Belvidere Rd, Grayslake, IL 60030-2061 | 2009-02-24 |
| 1770737199 | Advocate Condell Medical Center | General Acute Care Hospital | 1170 E Belvidere Rd, Grayslake, IL 60030-2061 | 2008-11-12 |
| 1114170115 | Christine Louise Jakubec | Audiologist | 1170 E Belvidere Rd, Suite 204, Grayslake, IL 60030-2061 | 2008-11-04 |
| 1881856821 | Nuha Mariam Shair | Pediatrics | 1170 E Belvidere Rd, Suite 106, Grayslake, IL 60030-2061 | 2008-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393781 | Camelot Care Centers, LLC | Clinic/Center | 34121 North Route 45 Suite 207, Grayslake, IL 60030 | 2020-10-13 |
| 1992347892 | Pier London | Social Worker | 18640 Belivdere Rd., Grayslake, IL 60030 | 2019-10-11 |
| 1972156529 | Elizabeth Reeve | Counselor | 18640 Belvidere, Grayslake, IL 60030 | 2019-07-23 |
| 1144725987 | Michael Kraft | Family Medicine | 1475 E. Belvidere Road, Suite 385, Grayslake, IL 60030 | 2018-03-26 |
| 1255850780 | Megan B March | Speech-Language Pathologist | 33089 N Battershall Rd, Grayslake, IL 60030 | 2017-09-15 |
| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
| 1184163628 | Surprenant Chiropractic LLC | Clinic/Center | 1227 N Illinois Route 83, Suite A, Grayslake, IL 60030 | 2017-02-16 |
| 1700230976 | Camelot Care Centers, LLC. | Foster Care Agency | 34121 North Route 45, Suite 207, Grayslake, IL 60030 | 2016-04-14 |
| 1932560414 | Vital Therapeutics Inc | Physical Therapist | 34121 N Us 45, Suite 101, Grayslake, IL 60030 | 2016-03-11 |
| 1093175804 | Zigma Visiting Physician, LLC | General Practice | 4 N Deer Point Dr, 1002, Hainesville, IL 60030 | 2016-03-07 |
| Find all providers in zip 60030 | ||||
| Taxonomy Code | 261QR0207X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile Mammography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801047030 | Northshore Imaging Services Inc | Clinic/Center | 807 E Golfview Dr, Mt Prospect, IL 60056-4324 | 2008-10-07 |
| 1235170317 | Condell Medical Center | Clinic/Center | 1435 N Hunt Club Rd, Gurnee, IL 60031-2656 | 2006-06-09 |
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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.