OB/Gyne Associates of Lake County, S.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036067062 Issued in IL

Legal business name

OB/GYNE ASSOCIATES OF LAKE COUNTY, S.C.

Practice address

890 Garfield Ave
Suite 200
Libertyville, IL 60048-4723

Phone

(847) 549-1818

Fax

(847) 680-1573

NPI assigned

Aug 26, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Richard McCloud Allen, M.D.NPI 1609948124

Title

Physician

Phone

(847) 549-1818

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Richard M Allen, M.D.

  • Specialist
  • Libertyville, IL
  • NPI 1609948124
  NPD (past) Authorized official

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1497748222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 GARFIELD AVE",
            "address_2": "SUITE 200",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484723",
            "telephone_number": "847-549-1818",
            "fax_number": "847-680-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 GARFIELD AVE",
            "address_2": "SUITE 200",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484723",
            "telephone_number": "847-549-1818",
            "fax_number": "847-680-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB/GYNE ASSOCIATES OF LAKE COUNTY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MCCLOUD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-549-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "036067062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067062",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophia Hope Kannenberg O' Bryan, PA-C
• Kara Colleen O'Neill, MS, CCC-SLP
• Oak Grove School District 68
• Oak Spring Medical Group Inc
• OB-Gyne Associates of Libertyville, SC
• Oluwatomiwa Obadare
• Garrett David Obenauf, DMD
• Jasmina P Oberhaus, DO
• Dawn Oberman, OTR/L
• Benz L Obrero

• All providers in Libertyville, IL
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.