| Lake County | |
|
4343 Old Grand Ave Gurnee IL 60031-2767 | |
| (773) 432-6491 | |
| Not Available |
| Full Name | Lake County |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4343 Old Grand Ave, Gurnee, Illinois |
| Authorized Official Name and Position | Marcella Klauer (EXECUTIVE ASSISTANT) |
| Authorized Official Contact | 7735725480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake County 4101 N Ravenswood Ave Chicago IL 60613-2193 Ph: (773) 432-6491 | Lake County 4343 Old Grand Ave Gurnee IL 60031-2767 Ph: (773) 432-6491 |
| NPI Number | 1306292248 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 09/10/2021 |
| Certification Date | 09/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306292248 | NPI | - | NPPES |
| 04133 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Evolve Youth & Family Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 N Riverside Dr Ste 201, Gurnee, IL 60031 Phone: 708-603-9499 | |
Dana Steiner, Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Nations Dr, Suite 202, Gurnee, IL 60031 Phone: 847-668-6290 Fax: 847-307-8488 | |
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