NPIMap

Organization Active NPI

NBHC NCTC Great Lakes

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Great Lakes, IL
National Provider Identifier
1295928257
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
NBHC NCTC GREAT LAKES
Practice address
3001 6TH St Ste a
Great Lakes, IL 60088-2833
Phone
(847) 688-4560
NPI assigned
Aug 23, 2007
Organization subpart
Yes
Parent organization
NAVAL HEALTH CLINIC GREAT LAKESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Authorized official

Name
Duwayne Griepentrog
Title
Comptroller
Phone
(847) 688-2888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary

Addresses

Primary practice location

3001 6TH St Ste a
Great Lakes, IL 60088-2833

Mailing address

3001 6TH St Ste a
Great Lakes, IL 60088-2833
Phone (847) 688-4560

National Provider Directory

National Provider Directory
Tax ID family
James a Lovell FHCC14 organizations share this tax ID, including this one
Part of
James a Lovell FHCC

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1295928257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 6TH ST STE A",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 6TH ST STE A",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NBHC NCTC GREAT LAKES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HEALTH CLINIC GREAT LAKES",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "GRIEPENTROG",
        "authorized_official_first_name": "DUWAYNE",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "847-688-2888"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.