Lake County Internal Medicine Associates, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKE COUNTY INTERNAL MEDICINE ASSOCIATES, LLC

Practice address

5911 Kildeer CT
Long Grove, IL 60047-5052

Phone

(847) 478-5108

NPI assigned

Jul 11, 2012

Last updated

Jul 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mariusz Milejczyk, M,D.NPI 1467598235

Title

President

Phone

(847) 478-5108

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Lake County Internal Medicine Assoc LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Lake County Internal Medicine Assoc LLC

  • Non-Pharmacy Dispensing Site
  • Gurnee, IL
  • NPI 1316434376
  NPD tax ID
• Lake County Internal Medicine Association LLC

  • Legal Medicine
  • Long Grove, IL
  • NPI 1265833958
  NPD tax ID

Locations

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.

• Mariusz Milejczyk, MD

  • Internal Medicine Physician
  • Libertyville, IL
  • NPI 1467598235
  Medicare reassignment NPD Authorized official
• Walter Reid Glaws, D O

  • Gastroenterology Physician
  • Gurnee, IL
  • NPI 1104828532
  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341964800000",
    "number": "1154686525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 KILDEER CT",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 KILDEER CT",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475052",
            "telephone_number": "847-478-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY INTERNAL MEDICINE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A",
        "authorized_official_last_name": "MILEJCZYK",
        "authorized_official_first_name": "MARIUSZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-478-5108",
        "authorized_official_credential": "M,D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy S Krieger-Erickson, L.C.P.C.
• Melissa Kron, MA, CCC-SLP
• Emanuela Anna Kulach, D.O
• Sindhu Kurup, MD
• Lanis Kuyzin, M.D.
• Lake County Internal Medicine Association LLC
• Ewelina Renata Lakomy
• Bryan Charles Layton Jr., O.D.
• Debra Levay, PT
• Lindsay Pearlman & Associates

• Internal Medicine Physician in Long Grove, IL
• Providers in Long Grove, 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 Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.