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Contact Information

LAKE COUNTY INTERNAL MEDICINE ASSOC LLC
15 TOWER CT.
STE 190
GURNEE, IL60031
 Phone: 888-590-0808
 Fax: 866-740-4689
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Non-Pharmacy Dispensing Site

332900000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for LAKE COUNTY INTERNAL MEDICINE ASSOC LLC

NPI # 1316434376
LBN Legal business name LAKE COUNTY INTERNAL MEDICINE ASSOC LLC
Authorized official MACKENZIE HAHN - (NCPDP COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/16/2018
Last updated 04/16/2018 - About 8 years ago
Identifiers
IL License # 036093940
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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