Organization
LAKE COUNTY PRIMARY CARE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BELLUCCI (OFFICE ADMINISTRATOR)
(847) 526-2151
Entity
Organization
Contact information
Practice address
15 TOWER CT, SUITE 255, GURNEE, IL 60031-3336
(847) 526-2151
(847) 526-2017
Mailing address
PO BOX 6037, WAUCONDA, IL 60084-6037
(847) 526-2151
(847) 526-2017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
IL
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Enumeration date
03/22/2017
Last updated
04/24/2018
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