# NBHC NTC GREAT LAKES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NAVAL HEALTH CLINIC GREAT LAKES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831383108
- **Legal business name:** NAVAL HEALTH CLINIC GREAT LAKES
- **Authorized official:** DUWAYNE GRIEPENTROG (COMPTROLLER)
- **Authorized official phone:** (847) 688-2888

## Contact information

- **Practice address:** 3001 6TH ST STE A, GREAT LAKES, IL 60088-2833
- **Practice address phone:** (847) 688-4560
- **Mailing address:** 3001 6TH ST STE A, GREAT LAKES, IL 60088-2833
- **Mailing address phone:** (847) 688-4560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/30/2007
- **Last updated:** 08/30/2007