Organization
LAKE COUNTY PHYSICAL MEDICINE, S.C.
Active
Organization
LAKE COUNTY PHYSICAL MEDICINE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN ATKINSON D.C. (PRESIDENT)
(847) 223-3158
Entity
Organization
Contact information
Practice address
15 COMMERCE DR, 108, GRAYSLAKE, IL 60030-7807
(847) 223-3158
Mailing address
15 COMMERCE DR, 108, GRAYSLAKE, IL 60030-7807
(847) 223-3158
(888) 481-4758
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.042751
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036.042751
IL
208D00000X
General Practice Physician
—
—
363L00000X
Nurse Practitioner
209-009124
IL
Other
Enumeration date
10/23/2013
Last updated
02/06/2014
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