Lake County Primary Care S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKE COUNTY PRIMARY CARE S.C.

Practice address

15 Tower CT
Suite 255
Gurnee, IL 60031-3336

Phone

(847) 526-2151

Fax

(847) 526-2017

NPI assigned

Mar 22, 2017

Organization subpart

No

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

Authorized official

Name

Jason Bellucci

Title

Office Administrator

Phone

(847) 526-2151

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1245761295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6037",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600846037",
            "telephone_number": "847-526-2151",
            "fax_number": "847-526-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TOWER CT",
            "address_2": "SUITE 255",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313336",
            "telephone_number": "847-526-2151",
            "fax_number": "847-526-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY PRIMARY CARE S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "BELLUCCI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-526-2151"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake County Center, LLC
• Lake County General and Vascular Surgical Associates, P.C.
• Lake County Head and Neck Specialists S.C.
• Lake County Internal Medicine Assoc LLC
• Lake County Pediatrics SC
• Lake County Vein Specialists, SC
• Lake Harbor Behavioral Health, LLC
• Lake Heart Specialists
• Lake Shore Gastroenterolgy SC
• Lake Shore Gastroenterology

• Internal Medicine Physician in Gurnee, IL
• Providers in Gurnee, 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 Apr 24, 2018; 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.