# ISLAND LAKE URGENT CARE INC

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

## Provider details

- **NPI number:** 1518445675
- **Authorized official:** DR. REGINALD EBIRIM MD (PRESIDENT)
- **Authorized official phone:** (217) 433-4418

## Contact information

- **Practice address:** 521 KORA LANE, ISLAND LAKE, IL 60042-8438
- **Practice address phone:** (847) 469-6971
- **Practice address fax:** (847) 469-6974
- **Mailing address:** 521 KORA LN, ISLAND LAKE, IL 60042-9101
- **Mailing address phone:** (847) 469-6971
- **Mailing address fax:** (847) 469-6974

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2018
- **Last updated:** 08/01/2018