NPIMap

Organization Active NPI

Lake County Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Antioch, IL
National Provider Identifier
1265090849
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LAKE COUNTY IMMEDIATE CARE, LLC
Practice address
420 E Il Route 173 Ste 101
Antioch, IL 60002-7284
Phone
(847) 652-9700
Fax
(847) 652-9710
NPI assigned
May 30, 2019
Organization subpart
Yes
Parent organization
PROMPTMED URGENT CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Authorized official

Name
John V Jurica, MDNPI 1669556593
Title
Medical Director
Phone
(815) 263-3486

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

420 E Il Route 173 Ste 101
Antioch, IL 60002-7284

Mailing address

65 E Monroe St Unit 4726
Chicago, IL 60603-5755
Phone (312) 753-5167

National Provider Directory

National Provider Directory
Part of
Lake County Immediate Care LLC

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1265090849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 E MONROE ST UNIT 4726",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606035755",
            "telephone_number": "312-753-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E IL ROUTE 173 STE 101",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600027284",
            "telephone_number": "847-652-9700",
            "fax_number": "847-652-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY IMMEDIATE CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROMPTMED URGENT CARE",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "JURICA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "815-263-3486",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.