NPIMap

Organization Active NPI

Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
National Provider Identifier
1306937289
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WAUKEGAN CLINIC CORP
Practice address
1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone
(847) 360-3000
NPI assigned
Sep 27, 2006
Last updated
Jul 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Authorized official

Name
Elizabeth Shiny George
Title
Cfo
Phone
(847) 360-4081

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Neurology Physician 2084N0400X NU

Addresses

Primary practice location

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Mailing address

1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone (847) 360-4081

Other practice location 1

15 Tower Ct Ste 210
Gurnee, IL 60031-3355
Phone (847) 360-3000

Other practice location 2

1616 Grand Ave Ste A
Waukegan, IL 60085-3676
Phone (847) 360-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061108000240 IL Part B Supplier - Clinic/Group Practice 4284631086 Receives reassigned benefits from 174 practitioners
Practice locations: Lindenhurst, IL; North Chicago, IL; Red Bud, IL; Round Lake, IL; Round Lake Beach, IL; Vernon Hills, IL; Waukegan, IL; Zion, IL…

National Provider Directory

National Provider Directory

Locations

15 Tower Ct
Ste 265
Gurnee, IL 60031
Phone (847) 360-9800

95 N Greenleaf St
#B
Gurnee, IL 60031
Phone (847) 599-1142

300 N Milwaukee Ave
Ste D
Lake Villa, IL 60046
Phone (847) 239-4756

2540 N Il Route 83
Round Lake Beach, IL 60073
Phone (847) 356-2752

565 Lakeview Pkwy
Ste 102
Vernon Hills, IL 60061
Phone (847) 438-1779

1616 Grand Ave
Ste B
Waukegan, IL 60085
Phone (847) 239-4756

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

Practitioners & affiliated clinicians

Practitioners 218

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.

View all 218

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1306937289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Tower Ct Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600313355",
            "country_code": "US",
            "telephone_number": "847-360-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1616 Grand Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600853676",
            "country_code": "US",
            "telephone_number": "847-360-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAUKEGAN CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "SHINY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-360-4081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

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