National Provider Identifier Database

NAVAL HEALTH CLINIC GREAT LAKES
Military/U.S. Coast Guard Outpatient

The Defense Health Program or U.S. Coast Guard funded ?fixed? facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A ?fixed? facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the ?fixed? facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.


Contact Information

NAVAL HEALTH CLINIC GREAT LAKES
3350 ILLINOIS ST
GREAT LAKES, IL60088-5230
Phone: 847-688-5568
Fax: 847-688-2289
Website:
Specialty Taxonomy Code
* Military/U.S. Coast Guard Outpatient 261QM1100X

* Indicates primary specialty

NPI Profile & details for NAVAL HEALTH CLINIC GREAT LAKES

NPI Number 1144557208
Legal business name
LBN
NAVAL HEALTH CLINIC GREAT LAKES
Authorized official JESSE GEIBE - (MEDICAL OFFICER)
Entity Organization
Organization subpart No
Enumeration date 11/11/2009
Last updated 11/11/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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