County of Lake

NPI #1992155022 in Waukegan, Illinois

Provider Information

NPI Number: 1992155022
Entity Type: Organization
Organization Name: County of Lake
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Jun 20, 2016
Last Updated: Sep 10, 2024

Practice Location

Address: 3004 GRAND AVE
City: Waukegan
State: Illinois
ZIP Code: 60085-2321
Phone: (847) 377-8000

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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