ENT Consultants of Lake County

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

042-002811 Issued in IL

Legal business name

ENT CONSULTANTS OF LAKE COUNTY

Practice address

755 S Milwaukee Ave
Ste 181
Libertyville, IL 60048-3253

Phone

(847) 816-1228

Fax

(847) 816-1262

NPI assigned

Sep 20, 2005

Last updated

Oct 5, 2012By 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

Mrs. Stacey M Wilcox

Title

Office Manager

Phone

(847) 816-1228

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1811982408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "STE 181",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-816-1228",
            "fax_number": "847-816-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "STE 181",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483253",
            "telephone_number": "847-816-1228",
            "fax_number": "847-816-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT CONSULTANTS OF LAKE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-816-1228",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "042-002811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036039785",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Bernard Elvove, M.D.
• Emergency Surgical Services of Lake County LLC
• Renee Lee Emery, MS, OTR/L
• Encompass Health Rehabilitation Hospital of Libertyville, LLC (Encompass Health Rehabilitation Institute of Libertyville)
• Lauren Engert, SLP
• Adam L Escobedo, APRN
• Alex Jose Escobedo, APRN
• Rochie Estrella, APN, CCRN, FNP-BC
• Evercare Health Management LLC
• Evolve North I PLLC

• Otolaryngology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.