OrganizationActive
Lake County Internal Medicine Assoc LLC
NPI 1316434376 · Non-Pharmacy Dispensing Site · Gurnee, IL
Provider details
- NPI number
- 1316434376
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Mackenzie Hahn, Ncpdp Coordinator(888) 590-0808
- License
- 036093940 (IL)
Specialties & taxonomies
Suppliers
Practice location
15 Tower Ct.
Ste 190
Gurnee, IL 60031
Phone: (888) 590-0808
Fax: (866) 740-4689
Approximate (ZIP-level) locationGet directions
Mailing address
200 Rittenhouse Circle
Bristol, PA 19007
Registry dates
- Enumerated
- 2018-04-16
- Last updated
- 2018-04-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.