COUNTY OF LAKE (NPI# 1811109184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811109184 |
| Entity Type | Organization |
| Organization Name | COUNTY OF LAKE |
| Other Organization Name | LAKE COUNTY HEALTH DEPARTMENT AND COMMUNITY HEALTH CENTER |
| Practice Address |
3002 Grand Ave Waukegan IL 60085-2321 |
| Mailing Address |
3010 Grand Avenue Waukegan IL 60085-2321 |
| Practice Telephone | 8473778200 |
| Practice Fax Number | 8473603185 |
| Mailing Telephone | 8473778180 |
| Mailing Fax Number | 8473361517 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-12-02 |
| Authorized Official Name | MR. MARK PFISTER (INTERIM EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8473778000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 251S00000X | Community/Behavioral Health | IL | Agencies | |
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Lake County Health Department and Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477036507 | County of Lake | Community/Behavioral Health | 18736 W Peterson Rd, Libertyville, IL 60048-1064 | 2018-09-14 |
| 1093262867 | County of Lake | Clinic/Center | 15872 W 21st St, Wadsworth, IL 60083-8918 | 2016-09-08 |
| 1861857401 | County of Lake | Clinic/Center | 420 Greenwood Dr, Round Lake Park, IL 60073-3448 | 2015-12-28 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1639588254 | County of Lake | Clinic/Center | 800 High School Dr, Round Lake, IL 60073-2951 | 2014-08-07 |
| 1912333576 | County of Lake | Community/Behavioral Health | 18698 W Peterson Road, Libertyville, IL 60048 | 2013-09-16 |
| 1578861761 | County of Lake | Clinic/Center | 9345 Winchester St, Lower Lake, CA 95457-5000 | 2011-03-11 |
| 1528370277 | County of Lake | Community/Behavioral Health | 4118 Greenleaf Ct Apt 202, Park City, IL 60085-7913 | 2010-07-10 |
| 1619101292 | County of Lake | Clinic/Center | 2615 Washington Street, Waukegan, IL 60085 | 2009-05-11 |
| 1477721496 | County of Lake | Clinic/Center | 2424 Washington St, Waukegan, IL 60085-5074 | 2008-02-12 |
| Street Address |
3002 GRAND AVE |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-2321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225663230 | Daisy Stephanie Zuluaga | Counselor | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2020-03-10 |
| 1548807373 | Thomas Lamar Wise-bey | Counselor | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2019-11-27 |
| 1669017711 | Matthew David Pikus | Counselor | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2019-11-13 |
| 1639720899 | Michelle Marie Grace | Counselor | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2019-09-27 |
| 1790346989 | Karina Ortiz | Registered Nurse | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2019-06-27 |
| 1184287666 | Audrey Ringer | Registered Nurse | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2019-04-19 |
| 1275007569 | Kelli A Ciolek | Counselor | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2019-01-20 |
| 1700356185 | Gloria Lara | Counselor | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2018-11-28 |
| 1801370457 | Hernan D Canales | Registered Nurse | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2018-09-19 |
| 1518478635 | Stephanie Nicole Sajuan | Counselor | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2017-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942752126 | Bam House Inc | Substance Abuse Rehabilitation Facility | 431 N Genesee St, Waukegan, IL 60085-4005 | 2016-11-03 |
| 1780061259 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 215 W Water St, Waukegan, IL 60085-5616 | 2015-05-04 |
| 1750644886 | Lake County Health Dept | Substance Abuse Rehabilitation Facility | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2012-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860729 | New Gen Ed Inc. | Substance Abuse Rehabilitation Facility | 1219 N Gary Ave, Carol Stream, IL 60188-9028 | 2020-10-28 |
| 1578187886 | Silver Glen Road Opco LLC | Substance Abuse Rehabilitation Facility | 41w400 Silver Glen Rd, St Charles, IL 60175-8453 | 2020-06-02 |
| 1669025672 | Gateway Foundation, Inc. | Substance Abuse Rehabilitation Facility | 25480 W Cedar Crest Ln Bldg A, Lake Villa, IL 60046-9744 | 2019-07-18 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1033673165 | Michael David Lauts | Substance Abuse Rehabilitation Facility | 215 E 25th St Apt 228, Sterling, IL 61081-1092 | 2019-01-23 |
| 1457829632 | Hope Behavioral Services At The Jeannine Brent Center Incorporated | Substance Abuse Rehabilitation Facility | 2319 Plainfield Rd, Crest Hill, IL 60403-1875 | 2018-11-06 |
| 1063989143 | Northwest Recovery Center LLC | Substance Abuse Rehabilitation Facility | 5352 N Lincoln Ave Ste 250, Chicago, IL 60625-2316 | 2018-10-26 |
| 1982182671 | Rosecrance, Inc. | Substance Abuse Rehabilitation Facility | 2835 N Sheffield Ave Ste 209, Chicago, IL 60657-5083 | 2018-08-03 |
| 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.