Lake County Health Department And Community Health Center | |
18698 W Peterson Rd Libertyville IL 60048-1052 | |
(847) 377-8510 | |
Not Available |
Full Name | Lake County Health Department And Community Health Center |
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Speciality | Clinic/Center |
Location | 18698 W Peterson Rd, Libertyville, Illinois |
Authorized Official Name and Position | Angela Cooper (CFO) |
Authorized Official Contact | 8473778000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lake County Health Department And Community Health Center 3010 Grand Ave Waukegan IL 60085-2321 Ph: (847) 377-8000 | Lake County Health Department And Community Health Center 18698 W Peterson Rd Libertyville IL 60048-1052 Ph: (847) 377-8510 |
NPI Number | 1679900229 |
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Provider Enumeration Date | 09/27/2013 |
Last Update Date | 09/10/2024 |
Medicare PECOS PAC ID | 7214838861 |
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Medicare Enrollment ID | O20141126001644 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679900229 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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