NPIMap

Organization Active NPI

Naval Health Clinic Great Lakes

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Great Lakes, IL
National Provider Identifier
1144557208
Registry record updated Nov 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
NAVAL HEALTH CLINIC GREAT LAKES
Practice address
3350 Illinois St
Great Lakes, IL 60088-5230
Phone
(847) 688-5568
Fax
(847) 688-2289
NPI assigned
Nov 11, 2009
Last updated
Nov 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2009

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

Authorized official

Name
Dr. Jesse Geibe, M.D.NPI 1669656054
Title
Medical Officer
Phone
(847) 688-6712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary

Addresses

Primary practice location

3350 Illinois St
Great Lakes, IL 60088-5230

Mailing address

3350 Illinois Street BLDG 1523
Apo, AE 60088-5230
Phone (846) 688-5568

National Provider Directory

National Provider Directory

Locations

3350 Illinois St
Great Lakes, IL 60088

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257897600000",
    "number": "1144557208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "3350 ILLINOIS STREET BLDG 1523",
            "city": "APO",
            "state": "AE",
            "postal_code": "600885230",
            "telephone_number": "846-688-5568",
            "fax_number": "847-688-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 ILLINOIS ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600885230",
            "telephone_number": "847-688-5568",
            "fax_number": "847-688-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVAL HEALTH CLINIC GREAT LAKES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A",
        "authorized_official_last_name": "GEIBE",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "MEDICAL OFFICER",
        "authorized_official_telephone_number": "847-688-6712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.