CRYSTAL LAKE FAMILY TREATMENT CENTER LTD (NPI# 1851353361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851353361 |
| Entity Type | Organization |
| Organization Name | CRYSTAL LAKE FAMILY TREATMENT CENTER LTD |
| Practice Address |
185 Heritage Drive Suite 3 Crystal Lake IL 60014 |
| Practice Telephone | 8154550310 |
| Practice Fax Number | 8154551210 |
| Mailing Telephone | 8154550310 |
| Mailing Fax Number | 8154551210 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2010-11-12 |
| Authorized Official Name | DR. JOHN S BALOCKI (PRESIDENT) |
| Authorized Official Telephone | 8154550310 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036073896 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036073896 | 05 |
| Street Address |
185 HERITAGE DRIVE SUITE 3 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801856117 | John S Balocki | Family Medicine | 185 Heritage Drive, Suite 3, Crystal Lake, IL 60014 | 2006-03-23 |
| 1104984368 | Douglas N Neal & Associates Ltd | Psychologist | 185 Heritage Drive, Crystal Lake, IL 60014 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265917876 | Global Med Pro LLC | Family Medicine | 741 S Mchenry Ave Ste C&d, Crystal Lake, IL 60014-7445 | 2018-09-28 |
| 1588921951 | Khyldoon Selim Bajwa | Family Medicine | 2813 Stonegate Dr, Crystal Lake, IL 60012-1033 | 2012-04-23 |
| 1356653570 | Anthony J Weston | Family Medicine | 525 E Congress Pkwy Ste 350, Crystal Lake, IL 60014-6271 | 2010-07-02 |
| 1700106028 | Sumaira Jabeen | Family Medicine | 741 S Mchenry Ave Ste C, Crystal Lake, IL 60014 | 2010-06-09 |
| 1801856117 | John S Balocki | Family Medicine | 185 Heritage Drive, Suite 3, Crystal Lake, IL 60014 | 2006-03-23 |
| 1174503510 | Family Medicine for Mchenry County | Family Medicine | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1725 | 2006-01-20 |
| 1356905194 | Illinois Primary & Immediate Care Inc | Family Medicine | 741 S Mchenry Ave Ste C, Crystal Lake, IL 60014-7445 | 2019-04-26 |
| 1356883599 | Centegra Primary Care LLC | Family Medicine | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2016-11-04 |
| 1972814267 | Krishanthi Dilrukshi Seneviratne | Family Medicine | 415 E Congress Pkwy Ste A, Crystal Lake, IL 60014-6248 | 2010-07-01 |
| 1508035304 | Shruti Bahadur | Family Medicine | 650 Dakota St Ste A, Crystal Lake, IL 60012 | 2008-02-26 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on CRYSTAL LAKE FAMILY TREATMENT CENTER LTD.
| 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.