COUNTY OF LAKE (NPI# 1992155022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992155022 |
| Entity Type | Organization |
| Organization Name | COUNTY OF LAKE |
| Other Organization Name | LAKE COUNTY HEALTH DEPARTMENT/COMMUNITY HEALTH CENTER |
| Practice Address |
3004 Grand Ave Waukegan IL 60085-2321 |
| Mailing Address |
3010 Grand Ave Waukegan IL 60085-2321 |
| Practice Telephone | 8473778000 |
| Mailing Telephone | 8473778000 |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-06-20 |
| Authorized Official Name | MRS. ANTONIO BELTRAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8473778000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lake County Health Department/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 |
3004 GRAND AVE |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-2321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720290091 | County of Lake | Community/Behavioral Health | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2007-05-07 |
| 1225591977 | Kari Marie Green | Counselor | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2019-04-10 |
| 1801358346 | Elizabeth Cole | Counselor | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2019-04-03 |
| 1952802464 | Michael A Dickey | Counselor | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2018-02-21 |
| 1154834851 | Erika N Hetland | Social Worker | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2017-11-16 |
| 1083125579 | Sylvia Sims Bolton | Counselor | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2017-10-24 |
| 1487178109 | Solomon Yacob Berhanu | Student in an Organized Health Care Education/Training Program | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2017-08-03 |
| 1659825396 | Kimberly Jean Watts | Counselor | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2016-08-11 |
| 1326412057 | Christopher Butler Sr. | Counselor | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2015-11-18 |
| 1568862340 | James Spiziri | Registered Nurse | 3004 Grand Ave, Waukegan, IL 60085-2321 | 2014-08-28 |
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| 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 | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1619101292 | County of Lake | Clinic/Center | 2615 Washington Street, Waukegan, IL 60085 | 2009-05-11 |
| 1235453309 | County of Lake | Clinic/Center | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2010-03-18 |
| 1376717702 | County of Lake | Clinic/Center | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2008-04-16 |
| 1174552293 | County of Lake | Clinic/Center | 2400 Belvidere Rd, Waukegan, IL 60085-6165 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567108 | Pillars Community Health | Clinic/Center | 15w458 91st St, Burr Ridge, IL 60527-6379 | 2020-08-06 |
| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1639791569 | Community Health Partnership of Illinois | Clinic/Center | 201 W Kenyon Rd Bldg D, Champaign, IL 61820-7892 | 2020-05-14 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1235769704 | Greater Elgin Family Care Center | Clinic/Center | 451 N Mclean Blvd, Elgin, IL 60123-3239 | 2020-01-23 |
| 1710517537 | Greater Elgin Family Care Center Integrated Health Home | Clinic/Center | 1100 Shirley Ave, Streamwood, IL 60107-3068 | 2020-01-21 |
| 1215578109 | Board of Trustees of Southern Illinois University | Clinic/Center | 205 S 24th St Ste 100, Quincy, IL 62301-4446 | 2019-10-02 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
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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.