COUNTY OF LAKE

NPI # 

Practice Address:

18698 W Peterson Rd

Libertyville, IL, 60048-1052

Practice Phone:

847-377-8510

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X