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General NPI Number Information
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NPI Number | 1245830967
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Entity Type | Organization
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Legal Business Name | CAPTAIN JAMES A LOVELL FEDERAL HEALTH CARE CENTER
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 3001 GREEN BAY RD BLDG 7
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-3048
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Country | US
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Telephone | 224-627-2804
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Fax | 224-610-3852
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Provider Business Mailing Address
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Address Line | 3001 GREEN BAY RD BLDG 7
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-3048
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Country | US
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Telephone |
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Fax | 224-610-3852
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT TO THE CME
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Name | MRS. CATHERINE A SPILLNER
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Credential | LCSW
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Telephone | 224-610-3009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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