Healthcare Provider Details

I. General information

NPI: 1720185911
Provider Name (Legal Business Name): LAKE COUNTY ACUTE CARE, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W HALF DAY RD
BUFFALO GROVE IL
60089-6591
US

IV. Provider business mailing address

75 REMIT DRIVE SUITE 1218
CHICAGO IL
60675-1218
US

V. Phone/Fax

Practice location:
  • Phone: 847-215-0000
  • Fax: 847-913-6947
Mailing address:
  • Phone: 800-701-3381
  • Fax: 239-939-1682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES M JOHNSON
Title or Position: LLP MANAGING PARTNER
Credential: M.D.
Phone: 800-253-5358