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Organization

TANNI SUPPORTIVE LIVING

Active
Parent organization
LAKE-COOK HEALTHCARE SERVICES
Other names
Lake-Cook Healthcare Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
LAKE-COOK HEALTHCARE SERVICES
Authorized official
LINDA TANNI APRN (APRN)
(847) 868-3003
Entity
Organization

Contact information

Practice address
2698 BELVIDERE RD UNIT A01B, WAUKEGAN, IL 60085-6006
(847) 868-3003
(224) 252-2997
Mailing address
1800 NATIONS DR STE 115, GURNEE, IL 60031-9171
(847) 868-3003

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13876593
CAQH
IL
Enumeration date
05/10/2021
Last updated
03/09/2026
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