LAKE COUNTY PHYSICIANS ASSOCIATION (NPI# 1760544514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760544514 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTY PHYSICIANS ASSOCIATION |
| Other Organization Name | SAINT THERESE PHYSICIANS ASSOCIATION |
| Practice Address |
2615 Washington St Waukegan IL 60085 |
| Practice Telephone | 8473602475 |
| Practice Fax Number | 8476256225 |
| Mailing Telephone | 8473602475 |
| Mailing Fax Number | 8476256225 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOSEPH LIBERATORE (DIRECTOR) |
| Authorized Official Telephone | 8473602445 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Saint Therese Physicians Association | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134280753 | Lake County Physicians Association | Health Maintenance Organization | 630 E Jefferson St, Rockford, IL 61107-4026 | 2006-12-13 |
| Street Address |
2615 WASHINGTON ST |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780684670 | Himani D. Dalia | Pathology | 2615 Washington St, St. Therese Medical Center, Waukegan, IL 60085-4980 | 2005-07-21 |
| 1194215137 | Hope Psychiatry Sc | Psychiatry & Neurology | 2615 Washington St, Waukegan, IL 60085-4980 | 2018-05-15 |
| 1497252449 | V Covington, LLC | Psychiatry & Neurology | 2615 Washington St, Waukegan, IL 60085-4980 | 2018-04-06 |
| 1134634116 | V Covington, LLC | Psychiatric Hospital | 2615 Washington St, Waukegan, IL 60085-4980 | 2017-12-12 |
| 1366896631 | Jennifer Luzentales | Nurse Practitioner | 2615 Washington St, Waukegan, IL 60085-4980 | 2016-04-22 |
| 1508220989 | Vista Health System | Clinic/Center | 2615 Washington St, Waukegan, IL 60085-4980 | 2016-04-11 |
| 1821463787 | Eva Amber Frasca | Nurse Practitioner | 2615 Washington St, Waukegan, IL 60085-4980 | 2015-12-03 |
| 1932578366 | Wendy Piekarz | Dietitian, Registered | 2615 Washington St, Waukegan, IL 60085-4980 | 2015-09-16 |
| 1497017230 | Anterpreet Dhanoyia | Psychiatry & Neurology | 2615 Washington St, Waukegan, IL 60085-4980 | 2012-06-07 |
| 1386845246 | Bridgid Silvela-bacaling | Nurse Practitioner | 2615 Washington St, Waukegan, IL 60085-4980 | 2007-05-29 |
| 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 | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958607 | Letisha Smith | Contractor | 1921 Michigan City Rd Apt 1e, Calumet City, IL 60409-3724 | 2020-09-29 |
| 1184249088 | Yanko I Stoykov | Contractor | 1807 W Locust Ln, Mt Prospect, IL 60056-4405 | 2020-06-16 |
| 1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
| 1245864784 | Kendall Divante Leonard | Contractor | 524 N Roberts Dr Apt 2b, Glenwood, IL 60425-2300 | 2020-02-24 |
| 1477185379 | Azar Garayev | Contractor | 300 Hudson Ct Apt 106, Wheeling, IL 60090-3184 | 2020-02-07 |
| 1578031183 | Yesenia Servin | Contractor | 2 Westbrook Corporate Ctr Ste 600, Westchester, IL 60154-5716 | 2018-11-13 |
| 1194205781 | Anais J Robles | Contractor | 1626 S Allport St, Chicago, IL 60608 | 2018-08-14 |
| 1225528524 | Tara Rada Nieberding | Contractor | 1701 Quincy Ave Ste 12, Naperville, IL 60540 | 2018-05-14 |
| 1710482542 | Lanisha Blockmon | Contractor | 8214 S Evans Ave, Chicago, IL 60619-5306 | 2018-03-25 |
| 1487157913 | Stavone Mcherron | Contractor | 3420 Fountainbleau Dr, Hazel Crest, IL 60429-2257 | 2018-03-12 |
| 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.