| Lake County Health Department/community Health Center | |
|
3004 Grand Ave Waukegan IL 60085-2321 | |
| (847) 377-8000 | |
| Not Available |
| Full Name | Lake County Health Department/community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3004 Grand Ave, Waukegan, 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 |
|---|---|
| Lake County Health Department/community Health Center 3010 Grand Ave Waukegan IL 60085-2321 Ph: (847) 377-8000 | Lake County Health Department/community Health Center 3004 Grand Ave Waukegan IL 60085-2321 Ph: (847) 377-8000 |
| NPI Number | 1992155022 |
|---|---|
| Provider Enumeration Date | 06/20/2016 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 7214838861 |
|---|---|
| Medicare Enrollment ID | O20161021000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992155022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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