National Provider Identifier Database

NBHC NCTC 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

NBHC NCTC GREAT LAKES
3001 6TH ST STE A
GREAT LAKES, IL60088-2833
Phone: 847-688-4560
Fax:
Website:
Specialty Taxonomy Code
* Military/U.S. Coast Guard Outpatient 261QM1100X

* Indicates primary specialty

NPI Profile & details for NBHC NCTC GREAT LAKES

NPI Number 1295928257
Legal business name
LBN
NBHC NCTC GREAT LAKES
Authorized official DUWAYNE GRIEPENTROG - (COMPTROLLER)
Entity Organization
Organization subpart Yes
Enumeration date 08/23/2007
Last updated 08/23/2007 - About 19 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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