Organization
COUNTY OF LAKE
Active
Other names
Lake County Health Department and Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA COOPER (CFO)
(847) 377-8000
Entity
Organization
Contact information
Practice address
24647 N MILWAUKEE AVE, VERNON HILLS, IL 60061-1567
(847) 377-7835
Mailing address
3010 GRAND AVE., WAUKEGAN, IL 60085
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
002330005
IL
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002330005
—
IL
Enumeration date
02/07/2008
Last updated
09/10/2024
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