| County Of Lake | |
|
4118 Greenleaf Ct Park City IL 60085-8509 | |
| (847) 377-8170 | |
| Not Available |
| Full Name | County Of Lake |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4118 Greenleaf Ct, Park City, Illinois |
| Authorized Official Name and Position | Angela Cooper (CFO) |
| Authorized Official Contact | 8473778000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| County Of Lake 3010 Grand Ave. Waukegan IL 60085 Ph: (847) 377-8180 | County Of Lake 4118 Greenleaf Ct Park City IL 60085-8509 Ph: (847) 377-8170 |
| NPI Number | 1659583920 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659583920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
County Of Lake Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4118 Greenleaf Ct Apt 202, Park City, IL 60085 Phone: 847-377-8000 |