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Organization
NBHC NCTC INPR GREAT LAKES
Active
Organization
NBHC NCTC INPR GREAT LAKES
Active
Parent organization
NAVAL HEALTH CLINIC GREAT LAKES
Organization subpart
Yes
Provider details
NPI number
Legal business name
NAVAL HEALTH CLINIC GREAT LAKES
Authorized official
DUWAYNE BROZEK (COMPTOLLER)
(847) 688-2888
Entity
Organization
Contact information
Practice address
3001 6TH ST STE A, GREAT LAKES, IL 60088-2833
(847) 688-4560
Mailing address
3001 6TH ST STE A, GREAT LAKES, IL 60088-2833
(847) 688-4560
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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