# LAKE COUNTY PRIMARY CARE S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245761295
- **Authorized official:** JASON BELLUCCI (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (847) 526-2151

## Contact information

- **Practice address:** 15 TOWER CT, SUITE 255, GURNEE, IL 60031-3336
- **Practice address phone:** (847) 526-2151
- **Practice address fax:** (847) 526-2017
- **Mailing address:** PO BOX 6037, WAUCONDA, IL 60084-6037
- **Mailing address phone:** (847) 526-2151
- **Mailing address fax:** (847) 526-2017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | IL | — |
| 207R00000X | Internal Medicine Physician | — | IL | Yes |

## Other

- **Enumeration date:** 03/22/2017
- **Last updated:** 04/24/2018