NPIMap

Organization Active NPI

County of Lake

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Vernon Hills, IL
National Provider Identifier
1417243288
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
071.006552 Issued in IL
Legal business name
COUNTY OF LAKE
Practice address
24647 N Milwaukee Ave
Vernon Hills, IL 60061-1576
Phone
(847) 377-7920
NPI assigned
Jun 21, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Dena Traylor, PSY.D.
Title
Director of Psychological Services
Phone
(847) 377-3675

Corporate family (same tax ID) 42

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

View all 42

National Provider Directory

National Provider Directory
Tax ID family
Lake County Mental Heal T (45 organizations share this tax ID)

Locations

215 W Water St
Waukegan, IL 60085
Phone (312) 226-7984

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 071.006552 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

24647 N Milwaukee Ave
Vernon Hills, IL 60061-1576

Mailing address

215 W Water St
Waukegan, IL 60085-5616
Phone (847) 377-3675

Other names 1

NPPES NPI Registry
  • Nineteenth Judicial Circuit Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 21, 2011.

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1417243288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W WATER ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855616",
            "telephone_number": "847-377-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24647 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611576",
            "telephone_number": "847-377-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "DIRECTOR OF PSYCHOLOGICAL SERVICES",
        "authorized_official_telephone_number": "847-377-3675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "IL",
            "license": "071.006552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nineteenth Judicial Circuit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.