County of Lake

NPI #1720290091 in Waukegan, Illinois

Provider Information

NPI Number: 1720290091
Entity Type: Organization
Organization Name: County of Lake
Primary Specialty: Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date: May 7, 2007
Last Updated: Aug 21, 2025

Practice Location

Address: 3004 GRAND AVE
City: Waukegan
State: Illinois
ZIP Code: 60085-2321
Phone: (847) 377-8273

Authorized Official

Name: ANGELA COOPER
Title: CFO
Phone: (847) 377-8000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Clinic/Center - Methadone — Methadone	261QM2800X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X	Primary

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