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NAVAL HEALTH CLINIC GREAT LAKES ILLINOIS NPI 1093044281


NPI Information

NPI: 1093044281
Provider Name: NAVAL HEALTH CLINIC GREAT LAKES ILLINOIS
Classification: Clinic/Center - 261QM1102X
Entity Type: Organization

Specialization: Military Outpatient Operational (Transportable) Component

Address:
3350 ILLINOIS ST
BLDG 1523
GREAT LAKES, IL
ZIP 60088
Phone: (847) 688-5568
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NAVAL HEALTH CLINIC GREAT LAKES ILLINOIS is a military outpatient operational (transportable) component clinic center in Great Lakes, IL. The provider is non-fixed facilities or distinct parts of a non-fixed facility, providing outpatient medical and dental services, primarily intended for DoD active duty. The entity is funded with other than Defense Health Program funding. Non-DoD active duty may receive services from this entity. Non-fixed facilities are generally deployed DoD health care activities, not providing services on or in association with a DoD fort or base. Non-fixed facilities include outpatient services furnished onboard ships. Non-fixed facilities also include deployed clinics. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. NAVAL HEALTH CLINIC GREAT LAKES ILLINOIS NPI is 1093044281. The provider is registered as an organization entity type.

The provider's business location address is:

3350 ILLINOIS ST
BLDG 1523
GREAT LAKES, IL
ZIP 60088-230
Phone: (847) 688-5568
Fax: (847) 688-4430

The provider's authorized official is Johnna Ann Morton .
The authorized official title is Independent Hospital Corpsman and has the following contact phone number (847) 688-5568.

The enumeration date for this NPI number is 12/17/2009 and was last updated on 12/17/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1102XClinic/CenterMilitary Outpatient Operational (Transportable) ComponentGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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