SURGEONS OF LAKE COUNTY LLC (NPI# 1417145301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417145301 |
| Entity Type | Organization |
| Organization Name | SURGEONS OF LAKE COUNTY LLC |
| Practice Address |
1870 W Winchester Rd Suite 112 Libertyville IL 60048-5358 |
| Practice Telephone | 8478167495 |
| Practice Fax Number | 8478167497 |
| Mailing Telephone | 8478167495 |
| Mailing Fax Number | 8478167497 |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2009-10-01 |
| Authorized Official Name | DR. SCOTT CHRISTOPHER OTTO (PRESIDENT) |
| Authorized Official Telephone | 8478167495 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 036109065 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1870 W WINCHESTER RD SUITE 112 |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-5358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144212382 | William A Martinez | Family Medicine | 1870 W Winchester Rd, Suite 145, Libertyville, IL 60048-5358 | 2005-08-15 |
| 1578006219 | Liberty Anesthesia Services LLC | Anesthesiology | 1870 W Winchester Rd, Suite 146, Libertyville, IL 60048-5358 | 2016-11-29 |
| 1790230944 | Julie Kero | Occupational Therapy Assistant | 1870 W Winchester Rd, Libertyville, IL 60048-5358 | 2016-08-17 |
| 1588118541 | Bushra Hussaini | Speech-Language Pathologist | 1870 W Winchester Rd, Libertyville, IL 60048-5358 | 2016-08-08 |
| 1790186955 | Jennifer Jensen | Nurse Practitioner | 1870 W Winchester Rd, Suite 241, Libertyville, IL 60048-5358 | 2014-09-08 |
| 1538568969 | Lauren Krapf | Speech-Language Pathologist | 1870 W Winchester Rd, 203, Libertyville, IL 60048-5358 | 2014-08-21 |
| 1669871471 | Katherine Bowers | Counselor | 1870 W Winchester Rd, Libertyville, IL 60048-5358 | 2014-08-18 |
| 1689087926 | Patricia Bress | Speech-Language Pathologist | 1870 W Winchester Rd, 203, Libertyville, IL 60048-5358 | 2014-06-04 |
| 1083956205 | Lauren Kliska | Occupational Therapist | 1870 W Winchester Rd, Ste 203, Libertyville, IL 60048-5358 | 2013-03-26 |
| 1114269347 | Hilary Kugler | Speech-Language Pathologist | 1870 W Winchester Rd, Ste 203, Libertyville, IL 60048-5358 | 2013-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346561123 | Kristin Nicole Vercillo | Surgery | 1870 W Winchester Rd Ste 112, Libertyville, IL 60048-5365 | 2010-06-16 |
| 1851387120 | Phillip Zaret | Surgery | 114 W Rockland Rd, Libertyville, IL 60048-2700 | 2005-09-22 |
| 1740275478 | Michael Zdon | Surgery | 1900 Hollister Dr, Suite 210, Libertyville, IL 60064-5284 | 2005-09-19 |
| 1497749162 | Scott C Otto | Surgery | 1641 N Milwaukee Ave, Suite 13, Libertyville, IL 60048 | 2005-09-08 |
| 1225169774 | Burton Miller, M.d., S.c. | Surgery | 890 Garfield Ave, 206, Libertyville, IL 60048-4723 | 2007-03-08 |
| 1891843199 | Scott Howell Miller | Surgery | 1870 W Winchester Rd, Suite 112, Libertyville, IL 60048-5358 | 2007-01-05 |
| 1831250794 | Burton Miller | Surgery | 890 Garfield Ave, 206, Libertyville, IL 60048-4723 | 2006-12-13 |
| 1295837417 | North Shore Surgical Associates, S.c. | Surgery | 1900 Hollister Dr, Suite # 210, Libertyville, IL 60048-5233 | 2006-09-01 |
| 1447265871 | William C Watson | Surgery | 1870 W Winchester Rd, Suite 112, Libertyville, IL 60048 | 2006-07-31 |
| 1902891674 | Robert Gerard Kummerer | Surgery | 890 Garfield Ave, Suite 101, Libertyville, IL 60048-4723 | 2005-09-19 |
| Find all providers in LIBERTYVILLE | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
Please comment or provide details below to improve the information on SURGEONS OF LAKE COUNTY LLC.
| 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.