NPIMap

Organization Active NPI

County of Lake

Doing business as Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
National Provider Identifier
1376717702
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNTY OF LAKE
Doing business as
Lake County Health Department and Community Health Center
Practice address
3010 Grand Ave
Waukegan, IL 60085-2321
Phone
(847) 377-8000
NPI assigned
Apr 16, 2008
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Sam Johnson
Title
Deputy Executive Director
Phone
(847) 377-8063

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X IL
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Health Service Clinic/Center 261QH0100X IL
Health Service Clinic/Center 261QH0100X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

3010 Grand Ave
Waukegan, IL 60085-2321

Mailing address

3010 Grand Ave
Waukegan, IL 60085-2321
Phone (847) 377-8000

Other names 1

  • Lake County Health Department and Community Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000192 IL Part B Supplier - Clinic/Group Practice 7214838861 Receives reassigned benefits from 148 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waukegan, IL; Zion, IL; Vernon Hills, IL; Round Lake Park, IL; Round Lake Beach, IL; Round Lake, IL; Park City, IL; North Chicago, IL…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Public Health or Welfare Agency
    • Waukegan, IL
    • NPI 1013920750

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Federally Qualified Health Center (FQHC)
    • Zion, IL
    • NPI 1023047164

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Waukegan, IL
    • NPI 1053623637

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Federally Qualified Health Center (FQHC)
    • North Chicago, IL
    • NPI 1083643118

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Federally Qualified Health Center (FQHC)
    • Waukegan, IL
    • NPI 1174552293

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Waukegan, IL
    • NPI 1174745160

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Federally Qualified Health Center (FQHC)
    • Waukegan, IL
    • NPI 1235453309

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Public Health or Welfare Agency
    • Waukegan, IL
    • NPI 1255342457

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Federally Qualified Health Center (FQHC)
    • Highland Park, IL
    • NPI 1285663328

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Waukegan, IL
    • NPI 1477765741

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Dept and Community Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Zion, IL
    • NPI 1538380647

    O20040116000192

    Same enrollment
  • County of Lake

    dba Lake County Health Department and Community Health Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Waukegan, IL
    • NPI 1568674836

    O20040116000192

    Same enrollment
View all 24

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1376717702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "DEPUTY EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-377-8063"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake County Health Department and Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 31, 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.