The Illinois Medical Assistance Treatment Program LLC
NPI 1407008998 · Clinic/Center · Waukegan, IL
The Illinois Medical Assistance Treatment Program LLC is a Clinic/Center organization in Waukegan, IL (NPI 1407008998).
Provider details
- NPI number
- 1407008998
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Richard Keller, Medical Director(847) 360-1019
- License
- A27740001A (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Green Dragonfly
Registry dates
- Enumerated
- 2008-10-16
- Last updated
- 2008-10-16
Frequently asked questions
- What is The Illinois Medical Assistance Treatment Program LLC's NPI number?
- The Illinois Medical Assistance Treatment Program LLC's National Provider Identifier (NPI) is 1407008998, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is The Illinois Medical Assistance Treatment Program LLC?
- The Illinois Medical Assistance Treatment Program LLC is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is The Illinois Medical Assistance Treatment Program LLC located?
- The Illinois Medical Assistance Treatment Program LLC's practice location on file with NPPES is 1738 Washington St, Waukegan, IL 60085-5137.
- What is The Illinois Medical Assistance Treatment Program LLC's phone number?
- The practice phone number listed in the NPPES registry for The Illinois Medical Assistance Treatment Program LLC is (847) 360-1019.
- Who is the authorized official for The Illinois Medical Assistance Treatment Program LLC?
- The authorized official listed on The Illinois Medical Assistance Treatment Program LLC's NPPES record is Richard Keller, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is The Illinois Medical Assistance Treatment Program LLC's NPI active?
- Yes — The Illinois Medical Assistance Treatment Program LLC's NPI (1407008998) is active in the NPPES registry as of the last update on 2008-10-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.