Lake County Pediatrics Sc

NPI #1114102530 in Gurnee, Illinois

Provider Information

NPI Number
1114102530
Entity Type
Organization
Organization Name
Lake County Pediatrics Sc
Primary Specialty
Pediatrics
Enumeration Date
Jan 3, 2008
Last Updated
Jan 3, 2008

Practice Location

Address
200 S GREENLEAF AVE
Address 2
SUITE E
City
Gurnee
ZIP Code
60031
Phone
(847) 336-0770

Authorized Official

Name
MARLENE JUCO TANQUILUT, MD
Title
PRESIDENT
Phone
(847) 336-0770

Specialties & Taxonomy Codes

Specialty
Pediatrics

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