County of Lake

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

800 High School Dr
Round Lake, IL 60073-2951

Phone

(847) 377-8531

NPI assigned

Aug 7, 2014

Last updated

Aug 31, 2026By the provider in NPPES

Organization subpart

No

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) 377-8000

Specialties & licenses 1

Addresses

Other names 1

• LAKE COUNTY HEALTH DEPARTMENT AND COMMUNITY HEALTH CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639588254. Details of each certification follow.

• CCN C41044 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN C41044

Legal name

COUNTY OF LAKE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 6, 2025

Last certification

Mar 6, 2025

Ownership / control type

For profit – corporation

Organization structure

OtherNon-profit

Enrollment address

800 High School Dr
Round Lake, IL 60073-2951

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• County of Lake

  dba Lake County Health Department and Community Health Center

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

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Libertyville, IL
  • NPI 1679900229

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department/Community Health Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waukegan, IL
  • NPI 1720290091

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Round Lake Beach, IL
  • NPI 1750310884

  7214838861

  Same PAC ID
• County of Lake

  dba Lake County Health Department/Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1992155022

  7214838861

  Same PAC ID

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

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1376717702

  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

Tax ID family

Lake County Health Dept43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Zion, IL
  • NPI 1023047164
  NPD tax ID
• 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
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • North Chicago, IL
  • NPI 1083643118
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1174552293
  NPD tax ID
• 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
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1235453309
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1255342457
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Highland Park, IL
  • NPI 1285663328
  NPD tax ID
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waukegan, IL
  • NPI 1356888515
  NPD tax ID
• County of Lake

  dba Nineteenth Judicial Circuit

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Vernon Hills, IL
  • NPI 1417243288
  NPD tax ID
• County of Lake

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1457272585
  NPD tax ID

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• County of Lake

  dba Lake County Health Department and Community Health Center

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

  Operational/Managerial Control

  CMS ownership
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  Operational/Managerial Control

  CMS ownership
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  Operational/Managerial Control

  CMS ownership
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  Operational/Managerial Control

  CMS ownership
• County of Lake

  dba Lake County Health Department and Community Health Center

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

  Operational/Managerial Control

  CMS ownership
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Libertyville, IL
  • NPI 1679900229

  Operational/Managerial Control

  CMS ownership
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Round Lake Beach, IL
  • NPI 1750310884

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 144

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.

• Idries Abdur-Rahman, M.D.

  • Obstetrics & Gynecology Physician
  • Ottawa, IL
  • NPI 1891727236
  NPD
• Jamil Abdur-Rahman, M.D.

  • Obstetrics & Gynecology Physician
  • Gurnee, IL
  • NPI 1710914189
  NPD
• Jean Ackermans

  • Clinical Social Worker
  • Mount Prospect, IL
  • NPI 1104290345
  NPD
• Amanda Adams, LPC, CADC

  • Counselor
  • Waukegan, IL
  • NPI 1710395512
  NPD
• Sana Shireen Ahmed, M.D.

  • Internal Medicine Physician
  • Waukegan, IL
  • NPI 1497985980
  NPD
• Nimat Akorede

  • Psychiatric/Mental Health Nurse Practitioner
  • Libertyville, IL
  • NPI 1760918403
  NPD
• Nagham A. Al-Bana, MD

  • Family Medicine Physician
  • Northbrook, IL
  • NPI 1811250681
  NPD
• Joyce Alex, APNP

  • Nurse Practitioner
  • Northbrook, IL
  • NPI 1265839625
  NPD
• Ayesha Ali, MD

  • Family Medicine Physician
  • Glenview, IL
  • NPI 1962453456
  NPD
• Sky A Anselm

  • Counselor
  • Waukegan, IL
  • NPI 1467904870
  NPD
• Sonia Antony, M.D.

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1033141494
  NPD
• Jonathan Arenas

  • Clinical Social Worker
  • Waukegan, IL
  • NPI 1871964197
  NPD

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1639588254",
    "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": "800 HIGH SCHOOL DR",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600732951",
            "telephone_number": "847-377-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "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": "847-377-8000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE COUNTY HEALTH DEPARTMENT AND COMMUNITY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Chiarello, OTR/L
• Angela M Cho
• Marcela Cobian
• Arthur Collier, CADC
• Counseling Corner LLC
• Rebecca Craig, LCPC
• Elisa Crespo Pavlatos
• Kelley Dagdick
• Elizabeth Ann Delimat, OTR/L
• Marinela Dilo, DMD

• Federally Qualified Health Center (FQHC) in Round Lake, IL
• Providers in Round Lake, IL by specialty
• Federally Qualified Health Center (FQHC) in Illinois

• 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; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.