Organization
LAKE COUNTY HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTEN TILLIS L.P.C. (COUNSELOR II)
(847) 377-8950
Entity
Organization
Contact information
Practice address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8950
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
178007626
IL
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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