Grayslake Family Health Center SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036098167 Issued in IL

Legal business name

GRAYSLAKE FAMILY HEALTH CENTER SC

Practice address

1475 E Belvidere Rd
Suite 312
Grayslake, IL 60030-2012

Phone

(847) 845-7213

Fax

(312) 694-0655

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alison S Holloway, MDNPI 1699751735

Title

Physician President

Phone

(847) 548-8430

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alison S Holloway, MD

  • Family Medicine Physician
  • Rosemont, IL
  • NPI 1699751735
  NPD (past) Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1215004874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 E BELVIDERE RD",
            "address_2": "SUITE 312",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302012",
            "telephone_number": "847-584-5721",
            "fax_number": "312-964-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 E BELVIDERE RD",
            "address_2": "SUITE 312",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302012",
            "telephone_number": "847-845-7213",
            "fax_number": "312-694-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYSLAKE FAMILY HEALTH CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "ALISON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "847-548-8430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036098167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098167",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grayslake CC District 46
• Grayslake Community High School District 127
• Grayslake Dental Crare
• Grayslake Dental Studio PLLC
• Grayslake Eyecare Assoc LTD
• Grayslake Fire Protection District
• Grayslake Oral and Maxillofacial Surgery
• Grayslake Orthodontics Inc
• Grayslake Rehabilitation and Complete Physical Therapy LLC
• Cheryl A Gross, RPH AND PHARM D

• Family Medicine Physician in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.