WESTERN LAKE


Address: 21 W Grand Ave, Fox Lake, IL 60020-1209
Phone: 8475879700

WESTERN LAKE (NPI# 1992893010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992893010
Entity Type Organization
Organization Name WESTERN LAKE
Other Organization Name COUNSELING & DUI PROGRAMS LLC
Practice Address 21 W Grand Ave
Fox Lake
IL 60020-1209
Practice Telephone 8475879700
Practice Fax Number 8475878584
Mailing Telephone 8475879700
Mailing Fax Number 8475878584
Enumeration Date 2006-10-11
Last Update Date 2008-07-16
Authorized Official Name MR. JEFF ROY HEDIEN (DIRECTOR/ SOLE MBR OWNER)
Authorized Official Telephone 8475879700
Authorized Official Credential MA NCC CADC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health A-1450-0002-A IL Agencies

Other Provider Identifier

State Issuer Identifier Type Code
DEPT OF HUMAN SERVICES OFFICE OF ALCOHOL & SUBSTANCE ABUSE (DHS/ A 1450 0002 A 01

Other Provider/Organization Names

Other Name Type Code
COUNSELING & DUI PROGRAMS LLC Former Legal Business Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
New York State Corporations WESTERN LAKE ONTARIO CHARTER ASSOCIATION, INC. John J Polandick, 177 Sherwood Dr, Hilton, Ny 14468
New York State Corporations WESTERN LAKE ONTARIO CONSERVANCY, LIMITED 4819 Bragg Schoolhouse Rd, Albion, Ny 14411
Washington State Corporations WESTERN LAKES CORPORATION 16377 Taylor Rd, Mount Vernon, WA 98273-8544

Office Location

Street Address 21 W GRAND AVE
City FOX LAKE
State IL
Zip Code 60020-1209

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043510621 Northwestern Lake Counseling Early Intervention Provider Agency 17 West Grand Ave., Fox Lake, IL 60020 2010-10-28
1124074653 American Drug Stores LLC Durable Medical Equipment & Medical Supplies 1350 S Route 12, Fox Lake, IL 60020 2006-05-26
1063903417 Crystal C Scholten Physical Therapist 1294 S Route 12, Fox Lake, IL 60020 2018-05-22
1639525116 Fox Lake Fire Protection District General Acute Care Hospital 306 Washington Ave, Fox Lake, IL 60020 2016-05-13
1598075269 David Torres Counselor 17 W Grand Ave, Fox Lake, IL 60020 2010-10-15
1972843175 Surgical Assistant Innovations, LLC Registered Nurse 1236 Shagbark Ct, Fox Lake, IL 60020-0806 2013-02-25
1073982583 Sharilee Shaver Social Worker 7105 Saint Tropez Ct, Fox Lake, IL 60020-1040 2015-09-15
1356679534 Darlene Krieger Counselor 17 W Grand Ave, Fox Lake, IL 60020-1209 2009-11-25
1992330278 Nancy D Bourke Counselor 34 W Grand Ave, Fox Lake, IL 60020-1224 2020-03-07
1790258408 Bailey Behavioral Health, LLC Counselor 34 W Grand Ave Ste 101, Fox Lake, IL 60020-1224 2019-01-04
Find all providers in zip 60020

Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144820648 Community Wellness Group Community/Behavioral Health 635 Argyle Ave, Flossmoor, IL 60422-1201 2020-10-26
1437758711 Gina Baldacci, Lcsw, LLC Community/Behavioral Health 231 Longridge Dr, Bloomingdale, IL 60108 2020-10-19
1790383610 Joni Lamb Therapy, LLC Community/Behavioral Health 1555 Sherman Ave # 308, Evanston, IL 60201-4421 2020-10-13
1811594906 Everyday Empowered Clinical Services, Ltd. Community/Behavioral Health 5117 Main St, Suite #7, Downers Grove, IL 60515 2020-10-02
1942817150 Pacem Wellness, LLC Community/Behavioral Health 8 Eagle Ctr Ste 12, O Fallon, IL 62269-1947 2020-09-30
1831703271 Boules Clinical Psychology Group Community/Behavioral Health 200 S Frontage Rd Ste 324, Burr Ridge, IL 60527-6953 2020-09-02
1336753896 Counseling Kennedy Shenberg Community/Behavioral Health 5752 N Campbell Ave Apt 1, Chicago, IL 60659-5080 2020-09-02
1265045371 Brightside Recovery Community/Behavioral Health 1667 Belvidere Rd, Belvidere, IL 61008-9306 2020-08-28
1902419021 Brightside Recovery Community/Behavioral Health 8041 186th St Ste B, Tinley Park, IL 60487-9344 2020-08-28
1700498573 Bobby E. Wright Comprehensive Behavioral Health Center, Inc. Community/Behavioral Health 5816 W Division St Fl 1, Chicago, IL 60651-1003 2020-08-21
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Competitor

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City FOX LAKE
Zip Code 60020

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Dataset Information

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.

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