TRI COUNTY MEDICAL LLC (NPI# 1194182188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194182188 |
| Entity Type | Organization |
| Organization Name | TRI COUNTY MEDICAL LLC |
| Practice Address |
4310 W Crystal Lake Rd Suite F Mchenry IL 60050-4214 |
| Mailing Address |
7611 Pershing Blvd Kenosha WI 53142-4317 |
| Practice Telephone | 8153633223 |
| Practice Fax Number | 8153633240 |
| Mailing Telephone | 2626973668 |
| Mailing Fax Number | 2626973500 |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |
| Authorized Official Name | JAY KHAN (PRESIDENT) |
| Authorized Official Telephone | 2626973668 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
T059603 | WI | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588041008 | Tri County Medical LLC | Clinic/Center | 7611 Pershing Blvd, Kenosha, WI 53142-4317 | 2015-05-05 |
| Street Address |
4310 W CRYSTAL LAKE RD SUITE F |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-4214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053341305 | Iqbal H Khan II | Podiatrist | 4310 W Crystal Lake Rd, Suite F, Mchenry, IL 60050-4214 | 2006-07-03 |
| 1487815775 | Sbk Surgical Ltd. | Clinic/Center | 4310 W Crystal Lake Rd, Mchenry, IL 60050-4214 | 2008-06-19 |
| 1366520876 | Judith A. Marquardt | Counselor | 4310 W Crystal Lake Rd, Suite I, Mchenry, IL 60050-4214 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184245375 | Specialty Surgicare, Ltd | Clinic/Center | 500 W Golf Rd Ste 102, Schaumburg, IL 60195-3503 | 2020-04-29 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1619519535 | Anderson Surgery Center LLC | Clinic/Center | 3403 Anderson Healthcare Drive, Edwardsville, IL 62025 | 2019-10-11 |
| 1922664622 | Premier Cardiac Surgery Center, LLC | Clinic/Center | 11560 S Kedzie Ave Ste 102, Merrionette Park, IL 60803-4517 | 2019-05-17 |
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1477017333 | Ontario Street Operatory | Clinic/Center | 22 W Ontario St, Chicago, IL 60654-5169 | 2019-01-24 |
| 1407329501 | Chicago Cosmetic Surgery Institute | Clinic/Center | 2335 S Michigan Ave, Chicago, IL 60616-2104 | 2019-01-10 |
| 1538647474 | Palos Health Surgery Center, LLC | Clinic/Center | 15300 West Ave Ste 260, Orland Park, IL 60462-4600 | 2018-08-02 |
| 1013493824 | Ann & Robert H. Lurie Children's Hospital of Chicago | Clinic/Center | 1121 Techny Rd, Northbrook, IL 60062-5503 | 2018-07-15 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
| 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.