Naval Health Clinic Great Lakes Illinois

Primary specialty

Military Outpatient Operational (Transportable) Component Clinic/CenterTaxonomy code 261QM1102X

Legal business name

NAVAL HEALTH CLINIC GREAT LAKES ILLINOIS

Practice address

3350 Illinois St
BLDG 1523
Great Lakes, IL 60088-5230

Phone

(847) 688-5568

Fax

(847) 688-4430

NPI assigned

Dec 17, 2009

Organization subpart

No

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

Authorized official

Name

Miss Johnna Ann Morton

Title

Independent Hospital Corpsman

Phone

(847) 688-5568

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1093044281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 ILLINOIS STREET",
            "address_2": "BLDG 1523",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600885230",
            "telephone_number": "847-688-5568",
            "fax_number": "847-688-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 ILLINOIS ST",
            "address_2": "BLDG 1523",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600885230",
            "telephone_number": "847-688-5568",
            "fax_number": "847-688-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVAL HEALTH CLINIC GREAT LAKES ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "JOHNNA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "INDEPENDENT HOSPITAL CORPSMAN",
        "authorized_official_telephone_number": "847-688-5568",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QM1102X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military Outpatient Operational (Transportable) Component",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford Loren Moudy II, I.D.C.
• James Patrick Muir, D.D.S.
• Jordan Munar
• John J Murphy, D.D.S.
• Naval Health Clinic Great Lakes
• NBHC NCTC Great Lakes
• NBHC NCTC Inpr Great Lakes
• NBHC NTC Great Lakes
• Dane Nelson, D.D.S.
• Andrew Trinh Nguyen, DDS

• Military Outpatient Operational (Transportable) Component Clinic/Center in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Military Outpatient Operational (Transportable) Component Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.