Lake County Associate of Internal Medicine , LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKE COUNTY ASSOCIATE OF INTERNAL MEDICINE , LLC

Practice address

1880 W Winchester Rd Ste 106
Libertyville, IL 60048-5321

Phone

(847) 367-8297

Fax

(847) 367-4277

NPI assigned

Jun 22, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Magdalena J Schanck

Title

Billing Manager

Phone

(847) 367-8297

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1003301052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 W WINCHESTER RD STE 106",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485321",
            "telephone_number": "847-367-8297",
            "fax_number": "847-367-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 W WINCHESTER RD STE 106",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485321",
            "telephone_number": "847-367-8297",
            "fax_number": "847-367-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY ASSOCIATE OF INTERNAL MEDICINE , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "SCHANCK",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "847-367-8297",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.