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Organization
LAKE COUNTY PEDIATRICS SC
Active
Organization
LAKE COUNTY PEDIATRICS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENE JUCO TANQUILUT MD (PRESIDENT)
(847) 336-0770
Entity
Organization
Contact information
Practice address
200 S GREENLEAF AVE, SUITE E, GURNEE, IL 60031
(847) 336-0770
(847) 336-0159
Mailing address
200 S GREENLEAF AVE, SUITE E, GURNEE, IL 60031
(847) 336-0770
(847) 336-0159
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
IL
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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