| Lake County Health Department And Community Health Center | |
|
3010 Grand Ave Waukegan IL 60085-2321 | |
| (847) 377-8180 | |
| (847) 336-1517 |
| Full Name | Lake County Health Department And Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3010 Grand Ave, Waukegan, Illinois |
| Authorized Official Name and Position | Irene T Pierce (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8473778000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake County Health Department And Community Health Center 3010 Grand Ave Waukegan IL 60085-2321 Ph: (847) 377-8000 | Lake County Health Department And Community Health Center 3010 Grand Ave Waukegan IL 60085-2321 Ph: (847) 377-8180 |
| NPI Number | 1164446712 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7214838861 |
|---|---|
| Medicare Enrollment ID | O20040116000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164446712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Illinois) | Primary |
| Provider Name | Ayesha A Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962453456 PECOS PAC ID: 4183606619 Enrollment ID: I20040607000968 |
| Provider Name | Lynn L Barnett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093852410 PECOS PAC ID: 0244210268 Enrollment ID: I20040723001108 |
| Provider Name | Grettel C Donahue |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477605913 PECOS PAC ID: 9537139654 Enrollment ID: I20040727001371 |
| Provider Name | Abdul Nmn Aziz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942290754 PECOS PAC ID: 5991774978 Enrollment ID: I20040927000843 |
| Provider Name | Jauren D Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831110220 PECOS PAC ID: 0042116659 Enrollment ID: I20050303000761 |
| Provider Name | Alvia Sabahat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699707851 PECOS PAC ID: 2365480860 Enrollment ID: I20050425000175 |
| Provider Name | Seema Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306949243 PECOS PAC ID: 9931149622 Enrollment ID: I20050512000356 |
| Provider Name | Hargurmukh P Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235152547 PECOS PAC ID: 6002852670 Enrollment ID: I20050705000868 |
| Provider Name | Ashok K Nagella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972536332 PECOS PAC ID: 0244260420 Enrollment ID: I20050817000545 |
| Provider Name | Adrianna J Dangremond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508802828 PECOS PAC ID: 8628000544 Enrollment ID: I20050831000391 |
| Provider Name | Aileen Benjakul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669491130 PECOS PAC ID: 3779517602 Enrollment ID: I20050921000053 |
| Provider Name | Susan C Lin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700826112 PECOS PAC ID: 8224051800 Enrollment ID: I20060110000422 |
| Provider Name | Kathy R Sonenthal |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1265452940 PECOS PAC ID: 7113920778 Enrollment ID: I20060821000326 |
| Provider Name | Idries Abdur Rahman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891727236 PECOS PAC ID: 4688671332 Enrollment ID: I20061023000367 |
| Provider Name | Jamil Abdur Rahman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710914189 PECOS PAC ID: 2860499506 Enrollment ID: I20061023000399 |
| Provider Name | Robert J Hartman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346336310 PECOS PAC ID: 2961409933 Enrollment ID: I20061106000051 |
| Provider Name | Angela C Mcelwee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659301661 PECOS PAC ID: 1355445073 Enrollment ID: I20070404000547 |
| Provider Name | Elisabeth A Desapereira |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134196678 PECOS PAC ID: 0941376297 Enrollment ID: I20080910000299 |
| Provider Name | Josephine Y Dinkha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518151679 PECOS PAC ID: 2062580640 Enrollment ID: I20081009000284 |
| Provider Name | Zina S Banna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487844098 PECOS PAC ID: 2668533241 Enrollment ID: I20081202000480 |
| Provider Name | Sonia J Antony |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033141494 PECOS PAC ID: 7416002159 Enrollment ID: I20090902000389 |
| Provider Name | Daram Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609895515 PECOS PAC ID: 5799824611 Enrollment ID: I20091204000489 |
| Provider Name | Lynn J Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790705051 PECOS PAC ID: 2961541883 Enrollment ID: I20091204000520 |
| Provider Name | Shehwar Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568622744 PECOS PAC ID: 0244373082 Enrollment ID: I20100202000880 |
| Provider Name | Elizabeth Nodine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346449527 PECOS PAC ID: 6507991759 Enrollment ID: I20100312001026 |
| Provider Name | Susan Felsenthal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437264512 PECOS PAC ID: 4385606664 Enrollment ID: I20100614000384 |
| Provider Name | Leslie S Zun |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376543421 PECOS PAC ID: 7012049174 Enrollment ID: I20100726000169 |
| Provider Name | Joshua B Nathan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720048572 PECOS PAC ID: 8729092812 Enrollment ID: I20101013000231 |
| Provider Name | Marina Smirnov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912135625 PECOS PAC ID: 8325232507 Enrollment ID: I20101102000066 |
| Provider Name | Maaza G Gamlak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699935817 PECOS PAC ID: 0143417188 Enrollment ID: I20101203000211 |
| Provider Name | Kenneth L Soyemi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467664946 PECOS PAC ID: 0345134896 Enrollment ID: I20110228000651 |
| Provider Name | James E Jupa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1437162278 PECOS PAC ID: 6901087634 Enrollment ID: I20110401000834 |
| Provider Name | Joanna E Caban |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023033610 PECOS PAC ID: 0244409621 Enrollment ID: I20110802000338 |
| Provider Name | Syeda N Zahedi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174788129 PECOS PAC ID: 1759552565 Enrollment ID: I20110927000230 |
| Provider Name | Ann Trauscht |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285612549 PECOS PAC ID: 7719151448 Enrollment ID: I20111115000677 |
| Provider Name | Craig Showalter |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1548299340 PECOS PAC ID: 9133396195 Enrollment ID: I20120117000269 |
| Provider Name | Luma S Sukkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831352038 PECOS PAC ID: 7911165154 Enrollment ID: I20120220000917 |
| Provider Name | Michele L Esser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083775597 PECOS PAC ID: 1759542244 Enrollment ID: I20120410000342 |
| Provider Name | Michele A Birkey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952327330 PECOS PAC ID: 1557522570 Enrollment ID: I20120418000186 |
| Provider Name | Kokeela R Rathi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215911805 PECOS PAC ID: 6709040835 Enrollment ID: I20120620000859 |
| Provider Name | Myleen Guzman Ablog |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760793574 PECOS PAC ID: 6305090192 Enrollment ID: I20130201000317 |
| Provider Name | Anatoliy Pyslar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003146267 PECOS PAC ID: 6800031048 Enrollment ID: I20130318000398 |
| Provider Name | Franceliz R Recinto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720324569 PECOS PAC ID: 0840424883 Enrollment ID: I20131007001533 |
| Provider Name | Omar T Cockey |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1154446318 PECOS PAC ID: 6406083534 Enrollment ID: I20131218000169 |
| Provider Name | Hanju Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912013012 PECOS PAC ID: 0143301168 Enrollment ID: I20141113000886 |
| Provider Name | Betsy K Luka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417202268 PECOS PAC ID: 0840440475 Enrollment ID: I20141208000320 |
| Provider Name | Kristin M Krivickas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073814067 PECOS PAC ID: 7911227228 Enrollment ID: I20150527001871 |
| Provider Name | Bonnie K Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881072924 PECOS PAC ID: 1658687546 Enrollment ID: I20150909001259 |
| Provider Name | Nuha M Shair |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881856821 PECOS PAC ID: 0547577306 Enrollment ID: I20150911001200 |
| Provider Name | Michael Fletcher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063802874 PECOS PAC ID: 8527376862 Enrollment ID: I20151006001334 |
| Provider Name | Nagham Al-bana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811250681 PECOS PAC ID: 8224348107 Enrollment ID: I20151104002576 |
| Provider Name | Toni Steres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972975639 PECOS PAC ID: 9638479801 Enrollment ID: I20151120000977 |
| Provider Name | Amalia Pepek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063818813 PECOS PAC ID: 3678877313 Enrollment ID: I20160201001696 |
| Provider Name | Jean N Ackermans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104290345 PECOS PAC ID: 3870897192 Enrollment ID: I20160208000706 |
| Provider Name | Yelena Kolezeva |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881644565 PECOS PAC ID: 7719283902 Enrollment ID: I20160315001029 |
| Provider Name | Mamerto S Villamonte |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1376532119 PECOS PAC ID: 6406154392 Enrollment ID: I20160408001238 |
| Provider Name | Gerald A Dismer |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1053301895 PECOS PAC ID: 4082912902 Enrollment ID: I20160411000127 |
| Provider Name | Izabela M Dlugosz |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578736971 PECOS PAC ID: 9830498864 Enrollment ID: I20160426001429 |
| Provider Name | Maria Roman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1881683076 PECOS PAC ID: 5395044333 Enrollment ID: I20160426001770 |
| Provider Name | Irina Bolotnikova |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1396816419 PECOS PAC ID: 7416256391 Enrollment ID: I20160427001101 |
| Provider Name | Igor Botvinnik |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1760553887 PECOS PAC ID: 6305145103 Enrollment ID: I20160428002305 |
| Provider Name | Valentin Cuarto |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1346395118 PECOS PAC ID: 6800185836 Enrollment ID: I20160516000704 |
| Provider Name | Patricia Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811357544 PECOS PAC ID: 5698064756 Enrollment ID: I20160524001127 |
| Provider Name | Chhaya Chandel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851384200 PECOS PAC ID: 9537459623 Enrollment ID: I20160601002371 |
| Provider Name | Joyce Alex |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265839625 PECOS PAC ID: 6103118302 Enrollment ID: I20160708000749 |
| Provider Name | Jacqueline D Christie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952768210 PECOS PAC ID: 4284920802 Enrollment ID: I20160908001066 |
| Provider Name | Ronald Alan Cheng |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1255544516 PECOS PAC ID: 3072800226 Enrollment ID: I20161003000957 |
| Provider Name | Heena D Pandya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487760195 PECOS PAC ID: 1355470790 Enrollment ID: I20161221000204 |
| Provider Name | Andrea L Grosskurth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497016752 PECOS PAC ID: 4981986387 Enrollment ID: I20170119001888 |
| Provider Name | Craig Conover |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588661607 PECOS PAC ID: 4183907611 Enrollment ID: I20170208000729 |
| Provider Name | Suzanne J Kellman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1356726806 PECOS PAC ID: 3375845514 Enrollment ID: I20170301000497 |
| Provider Name | Jenna M Rawski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669761441 PECOS PAC ID: 5991014755 Enrollment ID: I20170720002441 |
| Provider Name | John L Rocha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962912287 PECOS PAC ID: 3779841036 Enrollment ID: I20171215000154 |
| Provider Name | Shami Goyal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992931620 PECOS PAC ID: 3577710854 Enrollment ID: I20171226002064 |
| Provider Name | Sung A Cheon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104838440 PECOS PAC ID: 5294973152 Enrollment ID: I20180104000686 |
| Provider Name | Mina Girbes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386638823 PECOS PAC ID: 4789943176 Enrollment ID: I20180110000829 |
| Provider Name | Crystal J Stamps |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528579372 PECOS PAC ID: 3375803034 Enrollment ID: I20180129001844 |
| Provider Name | Sana S Ahmed |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497985980 PECOS PAC ID: 4082975107 Enrollment ID: I20180305002310 |
| Provider Name | Kelly L Ratz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114328275 PECOS PAC ID: 9931461860 Enrollment ID: I20180313000469 |
| Provider Name | Evelyn H Chou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003310269 PECOS PAC ID: 0143585034 Enrollment ID: I20180524000081 |
| Provider Name | Shannon Sunshine Trocki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851862817 PECOS PAC ID: 6406194398 Enrollment ID: I20190219003135 |
| Provider Name | Genevieve A Waldschmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982107322 PECOS PAC ID: 7618215500 Enrollment ID: I20190220000031 |
| Provider Name | Timberly Tb Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639658883 PECOS PAC ID: 5193064418 Enrollment ID: I20190305001028 |
| Provider Name | Leilani Gruezo Luell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437616836 PECOS PAC ID: 8628318292 Enrollment ID: I20190318001222 |
| Provider Name | Ikenna Obasi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750649455 PECOS PAC ID: 9739337668 Enrollment ID: I20190501003020 |
| Provider Name | Amy D Holmgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841636503 PECOS PAC ID: 1355674490 Enrollment ID: I20190605001306 |
| Provider Name | Carlie R Terchin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750827838 PECOS PAC ID: 8729311170 Enrollment ID: I20190618000283 |
| Provider Name | Carolyn A Bautista |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801959192 PECOS PAC ID: 5496723249 Enrollment ID: I20190829001265 |
| Provider Name | Guadalupe Lechuga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821410010 PECOS PAC ID: 5597094540 Enrollment ID: I20190917001570 |
| Provider Name | Nicole Hendrickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881242725 PECOS PAC ID: 9739411406 Enrollment ID: I20191029003523 |
| Provider Name | Brian Jason Salzverg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669853891 PECOS PAC ID: 2860792256 Enrollment ID: I20191102000048 |
| Provider Name | Kerrie D Fish |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669730198 PECOS PAC ID: 0345572855 Enrollment ID: I20191104000746 |
| Provider Name | Jessica L Barrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093356974 PECOS PAC ID: 9032541099 Enrollment ID: I20191112002581 |
| Provider Name | Mussarat I Arshad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801968953 PECOS PAC ID: 7315373594 Enrollment ID: I20200206001829 |
| Provider Name | Maria Molnar |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1417519638 PECOS PAC ID: 4587090774 Enrollment ID: I20200206001907 |
| Provider Name | Spiros J Lafazanos |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1215926290 PECOS PAC ID: 1759717945 Enrollment ID: I20200206001925 |
| Provider Name | Leslie G Villalobos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902457468 PECOS PAC ID: 5496181489 Enrollment ID: I20200211002160 |
| Provider Name | Sophie Mbua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811534902 PECOS PAC ID: 4688002314 Enrollment ID: I20200311002817 |
| Provider Name | Nimat N Akorede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760918403 PECOS PAC ID: 6305274036 Enrollment ID: I20200312000001 |
| Provider Name | Laura A Kresch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679091185 PECOS PAC ID: 0446516751 Enrollment ID: I20200422002380 |
| Provider Name | Suketu Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629614631 PECOS PAC ID: 6608291059 Enrollment ID: I20200803001718 |
| Provider Name | Rajbir Kaur Grewal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669904371 PECOS PAC ID: 5496011207 Enrollment ID: I20201202001742 |
| Provider Name | Bindu Mangat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578804910 PECOS PAC ID: 0648688036 Enrollment ID: I20210423002002 |
| Provider Name | Nicole J Vargas |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619551405 PECOS PAC ID: 6608275375 Enrollment ID: I20210528002113 |
| Provider Name | Lorena Maposito |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265960769 PECOS PAC ID: 6901205616 Enrollment ID: I20210601000938 |
| Provider Name | Saranya Ravichandran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992158737 PECOS PAC ID: 2860897766 Enrollment ID: I20210816001464 |
| Provider Name | Jamie Christine Esmon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235621624 PECOS PAC ID: 7719382639 Enrollment ID: I20210816002137 |
| Provider Name | Viktoriya Rouse-freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932747078 PECOS PAC ID: 8729479944 Enrollment ID: I20211223001506 |
| Provider Name | Sky A Anselm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467904870 PECOS PAC ID: 9032500277 Enrollment ID: I20211227000516 |
| Provider Name | Kathryn M Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689223232 PECOS PAC ID: 3072904937 Enrollment ID: I20220103001928 |
| Provider Name | Aisha Darko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285304105 PECOS PAC ID: 9436544368 Enrollment ID: I20220311000988 |
| Provider Name | Brittany Anne Orduna Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285344358 PECOS PAC ID: 0345610259 Enrollment ID: I20230110000284 |
| Provider Name | Lundon Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114367562 PECOS PAC ID: 7719120989 Enrollment ID: I20230309002357 |
| Provider Name | Angela A J Almendarez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356840029 PECOS PAC ID: 2961876727 Enrollment ID: I20230316002516 |
| Provider Name | Lana Nye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780167825 PECOS PAC ID: 6507221785 Enrollment ID: I20230421000829 |
| Provider Name | Lindsay Kay Baukert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760890313 PECOS PAC ID: 4486960481 Enrollment ID: I20230711000596 |
| Provider Name | Michael Preissing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285102038 PECOS PAC ID: 0840650636 Enrollment ID: I20230712000348 |
| Provider Name | Lori Ella Wysong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881046324 PECOS PAC ID: 1254615891 Enrollment ID: I20231216000337 |
| Provider Name | Jonathan Arenas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871964197 PECOS PAC ID: 6103276639 Enrollment ID: I20231227000160 |
| Provider Name | Anne-marie Kane |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750753299 PECOS PAC ID: 6901256320 Enrollment ID: I20231228000396 |
| Provider Name | Nicole Krause |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629396148 PECOS PAC ID: 8729438940 Enrollment ID: I20231229000647 |
| Provider Name | Lisa Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285985655 PECOS PAC ID: 9931559176 Enrollment ID: I20231229001351 |
| Provider Name | Abigail Caitlin Hoffmann |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144628512 PECOS PAC ID: 9335599588 Enrollment ID: I20231229001569 |
| Provider Name | Victoria Lecorian Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083094791 PECOS PAC ID: 2163732884 Enrollment ID: I20240104002246 |
| Provider Name | Dustin Makela |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578846259 PECOS PAC ID: 0345691168 Enrollment ID: I20240105002437 |
| Provider Name | Teresita Rodriguez Florido |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588448880 PECOS PAC ID: 7719338318 Enrollment ID: I20240108005877 |
| Provider Name | Guillermina Figueroa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255980991 PECOS PAC ID: 6800247404 Enrollment ID: I20240108005914 |
| Provider Name | Amanda Catherine Labarbera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174039556 PECOS PAC ID: 6800247131 Enrollment ID: I20240110004135 |
| Provider Name | Anita Marie Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447676598 PECOS PAC ID: 6002268570 Enrollment ID: I20240119002889 |
| Provider Name | Amy Catherine Storm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437423662 PECOS PAC ID: 9931551231 Enrollment ID: I20240123002157 |
| Provider Name | Amy Lynn Greskiw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831471572 PECOS PAC ID: 0345692539 Enrollment ID: I20240124000410 |
| Provider Name | Mckenzie Lee Endsley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962988196 PECOS PAC ID: 3779936414 Enrollment ID: I20240129003402 |
| Provider Name | Kaitlin Gosch Schaber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407301575 PECOS PAC ID: 6507219045 Enrollment ID: I20240131002470 |
| Provider Name | Jason Sutton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174819320 PECOS PAC ID: 5496108854 Enrollment ID: I20240201001650 |
| Provider Name | Heather Robbins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487935664 PECOS PAC ID: 5890148290 Enrollment ID: I20240201003000 |
| Provider Name | Allison Faye Wollert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164994562 PECOS PAC ID: 8224471420 Enrollment ID: I20240205002320 |
| Provider Name | Angie Stefani |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033535307 PECOS PAC ID: 9830532076 Enrollment ID: I20240205003482 |
| Provider Name | Kandyce Mcconico |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912484916 PECOS PAC ID: 5092158261 Enrollment ID: I20240206000131 |
| Provider Name | Stephanie Magen Valentin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306267836 PECOS PAC ID: 4587007307 Enrollment ID: I20240208003278 |
| Provider Name | Edith Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386917391 PECOS PAC ID: 8224471693 Enrollment ID: I20240213002518 |
| Provider Name | Ale Bugaro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609009604 PECOS PAC ID: 3476998519 Enrollment ID: I20240229000054 |
| Provider Name | Warren Heard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972851426 PECOS PAC ID: 9234574294 Enrollment ID: I20240229000984 |
| Provider Name | Todd S Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114291911 PECOS PAC ID: 6305281361 Enrollment ID: I20240229001055 |
| Provider Name | John Dichtl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639432909 PECOS PAC ID: 1658716626 Enrollment ID: I20240229001121 |
| Provider Name | Kelly Goggin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922455120 PECOS PAC ID: 5799120762 Enrollment ID: I20240229001298 |
| Provider Name | Jordana Elizabeth Ballesteros |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922788454 PECOS PAC ID: 2961847934 Enrollment ID: I20240229001323 |
| Provider Name | Amanda Adams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710395512 PECOS PAC ID: 6608211602 Enrollment ID: I20240229002527 |
| Provider Name | Thomas F Purnell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043588296 PECOS PAC ID: 4284070368 Enrollment ID: I20240312000483 |
Becker Group Home Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 448 N Genesee St, Waukegan, IL 60085 Phone: 847-244-9343 Fax: 847-244-9540 | |
Cognitive Pathways Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Washington St, Suite 403, Waukegan, IL 60085 Phone: 224-733-1615 Fax: 224-733-1620 | |
Walter L. Cherry Group Home Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 421 W Water St, Waukegan, IL 60085 Phone: 847-360-9560 Fax: 847-360-0195 | |
Lake County Health Department And Community Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3010 Grand Ave, Waukegan, IL 60085 Phone: 847-377-8000 | |
Truth Youth & Family Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Washington St., 300 B/c, Waukegan, IL 60085 Phone: 224-489-7773 | |
Arden Shore Child And Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Washington St, Suite 200, Waukegan, IL 60085 Phone: 847-662-4464 Fax: 847-662-4530 |