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General NPI Number Information
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NPI Number | 1821953902
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Entity Type | Organization
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Legal Business Name | PADS LAKE COUNTY INC.
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1800 GRAND AVE
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City | WAUKEGAN
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State | IL
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Zip | 60085-3582
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Country | US
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Telephone | 847-689-4357
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Fax | 847-689-0509
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Provider Business Mailing Address
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Address Line | 1800 GRAND AVE
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City | WAUKEGAN
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State | IL
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Zip | 60085-3582
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Country | US
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Telephone | 847-689-4357
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Fax | 847-689-0509
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE & OPERATIONS
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Name | ERIC FOOTE
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Credential |
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Telephone | 847-689-0597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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