County of Lake

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

COUNTY OF LAKE

Doing business as

Lake County Health Department and Community Health Center

Practice address

3010 Grand Ave.
Waukegan, IL 60085

Phone

(847) 377-8000

NPI assigned

May 2, 2007

Last updated

Aug 31, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

COUNTY OF LAKEAs reported in NPPES

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

Authorized official

Name

Sam Johnson

Title

Deputy Executive Director

Phone

(847) 377-8000

Specialties & licenses 2

Addresses

Other names 1

• Lake County Health Department and Community Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Zion, IL
  • NPI 1023047164

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1053623637

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • North Chicago, IL
  • NPI 1083643118

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1174552293

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1235453309

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1255342457

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Highland Park, IL
  • NPI 1285663328

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1376717702

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1477765741

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Dept and Community Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Zion, IL
  • NPI 1538380647

  O20040116000192

  Same enrollment
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1568674836

  O20040116000192

  Same enrollment

Tax ID family

Lake County Health Dept43 organizations share this tax ID, including this one

Part of

Lake County Health Dept

Other organizations with this tax ID 42

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

• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Zion, IL
  • NPI 1023047164
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1053623637
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • North Chicago, IL
  • NPI 1083643118
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1174552293
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1235453309
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1255342457
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Highland Park, IL
  • NPI 1285663328
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waukegan, IL
  • NPI 1356888515
  NPD tax ID
• County of Lake

  dba Nineteenth Judicial Circuit

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Vernon Hills, IL
  • NPI 1417243288
  NPD tax ID
• County of Lake

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1457272585
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Libertyville, IL
  • NPI 1477036507
  NPD tax ID

Practitioners 3

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.

• Zeruya Gaddam, APRN

  • Family Nurse Practitioner
  • South Holland, IL
  • NPI 1578304366
  NPD
• Paul Edwin Kraus, LCPC

  • Professional Counselor
  • Waukegan, IL
  • NPI 1952987216
  NPD
• Siobhan Elizabeth Romano, NP

  • Women's Health Nurse Practitioner
  • Waukegan, IL
  • NPI 1427854728
  NPD

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1174745160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8180",
            "fax_number": "847-336-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE.",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-377-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF LAKE",
        "enumeration_date": "2007-05-02",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "DEPUTY EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-377-8000"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake County Health Department and Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Coultas
• Lindsay Brock Coulter, LPC
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake

• Mental Health Clinic/Center (Including Community Mental Health Center) in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.