JAMES A LOVELL FHCC (NPI# 1407955032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407955032 |
| Entity Type | Organization |
| Organization Name | JAMES A LOVELL FHCC |
| Other Organization Name | USS TRANQ DENTAL PHCY |
| Practice Address |
3420 Illinois St Uss Tranquilityah14 Med Cln 1017 Great Lakes IL 60088-3161 |
| Mailing Address |
James A Lovell Fhcc Po Box 322 Great Lakes IL 60088 |
| Practice Telephone | 8476882100 |
| Mailing Telephone | 2246104232 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2015-08-07 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2025023 | 01 |
| Other Name | Type Code |
|---|---|
| USS TRANQ DENTAL PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043625981 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 2630 Green Bay Rd Bldg 3452, North Chicago, IL 60088-3303 | 2014-06-30 |
| 1508965120 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 2470 Sampson St Bldg 237, Great Lakes, IL 60088-2942 | 2006-09-21 |
| 1336248962 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 3452 Greenbay Rd Bldg 3452, Great Lakes, IL 60088 | 2006-09-21 |
| 1801858741 | James A Lovell Fhcc | Clinic/Center | 2470 Sampson Street, Bldg 237, Great Lakes, IL 60088 | 2006-04-05 |
| 1447665690 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 2470 Sampson St Bldg 237, North Chicago, IL 60088-2942 | 2014-06-26 |
| 1639276488 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 3001a Sixth Street, Great Lakes, IL 60088-5230 | 2006-09-20 |
| 1548367394 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 3420 Illinois St, Ah14 Medical Clinic, Great Lakes, IL 60088-3161 | 2006-09-20 |
| Street Address |
3420 ILLINOIS ST USS TRANQUILITYAH14 MED CLN 1017 |
| City | GREAT LAKES |
| State | IL |
| Zip Code | 60088-3161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952385148 | Jason Todd Holdeman | Psychologist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2005-12-01 |
| 1750851788 | Claire Kubiesa | Psychologist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2018-12-03 |
| 1003342536 | Emily J Baker | Physical Therapist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2017-05-03 |
| 1346603594 | Laura Megan Logeman | Physician Assistant | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2016-04-04 |
| 1225407539 | Kevin O'connor | Physician Assistant | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2015-09-16 |
| 1245595776 | Alma Teresa C Molino | Psychologist | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2012-07-10 |
| 1245529304 | Erin Graham | Student in an Organized Health Care Education/Training Program | 3420 Illinois St, Bldg 1007, Great Lakes, IL 60088-3161 | 2011-03-29 |
| 1588895742 | Kermit Salivia | Family Medicine | 3420 Illinois St, Great Lakes, IL 60088-3161 | 2009-08-05 |
| 1083898290 | Warren K Kennedy | Physician Assistant | 3420 Illinois St, Great Lakes, IL 60088-3120 | 2007-12-24 |
| 1346435112 | Jason Yungsup Kim | Family Medicine | 3420 Illinois St, Uss Tranquillity Clinic 1007, Great Lakes, IL 60088-3161 | 2007-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858228 | Kathryn Ann Bird | Dentist | 3440 W Ohio St, Uss Osborne Branch Dental Clinic, Great Lakes, IL 60088 | 2019-12-18 |
| 1740775576 | Jonathan William Criter | Dentist | 3400 Ohio St, Great Lakes, IL 60088 | 2018-06-25 |
| 1134598733 | True Xiong | Dentist | Zachary & Elizabeth Fisher Medical & Dental Clinic, 2470 Sampson Street, Apo, AA 60088 | 2015-09-24 |
| 1447685771 | Lisa Carol Perrone | Dentist | Fhcc Lovell Bldg 237 Dental, Navsta Great Lakes, North Chicago, IL 60088 | 2013-09-05 |
| 1437438421 | David Lawrence Green | Dentist | 2410 Samson St., Bldg 237, Great Lakes, IL 60088 | 2011-08-09 |
| 1164730602 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois Street, Great Lakes, IL 60088 | 2010-09-17 |
| 1598073439 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois St, Bldg 1007, Great Lakes, IL 60088 | 2010-09-14 |
| 1164736302 | Clinton Lariscy | Military Health Care Provider | 3355 Illinois St, Recruit Training Command Great Lakes, Great Lakes, IL 60088 | 2010-07-29 |
| 1083943906 | James Doll | Dentist | 2608 Paul Jones St, Great Lakes, IL 60088 | 2009-12-24 |
| 1396996823 | Kelly Robert Lanning | Dentist | 3001 A 6th St Bhc 237, Naval Hospital Great Lakes- Dental Dept., Great Lakes, IL 60088 | 2008-10-02 |
| Find all providers in zip 60088 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164730602 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois Street, Great Lakes, IL 60088 | 2010-09-17 |
| 1598073439 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois St, Bldg 1007, Great Lakes, IL 60088 | 2010-09-14 |
| 1831406719 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 3440 Ohio St, Bldg 1017, Great Lakes, IL 60088-3155 | 2010-09-13 |
| 1790092674 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2630 Green Bay Rd, Bldg 3452, Great Lakes, IL 60088-3303 | 2010-09-13 |
| 1508965120 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 2470 Sampson St Bldg 237, Great Lakes, IL 60088-2942 | 2006-09-21 |
| 1336248962 | James A Lovell Fhcc | Military/U.S. Coast Guard Pharmacy | 3452 Greenbay Rd Bldg 3452, Great Lakes, IL 60088 | 2006-09-21 |
| 1538574777 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2410 Sampson St Bldg 237, Great Lakes, IL 60088-2942 | 2014-06-26 |
| 1316254295 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2410 Sampson St, Bldg 237, Great Lakes, IL 60088-2942 | 2010-09-13 |
| 1710294681 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 3001 6th St Ste A, Bldg 200h Pharmacy, Great Lakes, IL 60088-2833 | 2010-09-13 |
| 1407918360 | Uss Tranq - Turn Two Phcy | Military/U.S. Coast Guard Pharmacy | 3420 Illinois Street, Great Lakes, IL 60088 | 2006-12-15 |
| Find all providers in GREAT LAKES | ||||
| City | GREAT LAKES |
| Zip Code | 60088 |
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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.