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LAKE COUNTY INTERNAL MEDICINE ASSOCIATION LLC NPI 1265833958


NPI Information

NPI: 1265833958
Provider Name: LAKE COUNTY INTERNAL MEDICINE ASSOCIATION LLC
Classification: Legal Medicine - 173000000X
Entity Type: Organization

CLIA Number: 14D2117292

Address:
5911 KILDEER CT
LONG GROVE, IL
ZIP 60047
Phone: (847) 672-8373
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LAKE COUNTY INTERNAL MEDICINE ASSOCIATION LLC is a legal medicine in Long Grove, IL. The provider is the specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. LAKE COUNTY INTERNAL MEDICINE ASSOCIATION LLC NPI is 1265833958. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5911 KILDEER CT
LONG GROVE, IL
ZIP 60047-052
Phone: (847) 672-8373
Fax: (815) 464-9285

The provider's authorized official is Mariusz Milejczyk .
The authorized official title is M.d. and has the following contact phone number (847) 596-7426.

The CLIA number assigned to this NPI record is 14D2117292 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/12/2014 and was last updated on 9/12/2014.


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
1173000000XLegal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P01139269OTHERILLINOISRAILROAD MEDICARE INDIVIDUAL
2DT3947OTHERILLINOISRAILROAD MEDICARE
3IL7339MEDICARE PINILLINOIS
4IL7339001MEDICARE UPINILLINOIS

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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