Organization · Type 2 NPI
Naval Health Clinic Great Lakes Illinois
Military Outpatient Operational (Transportable) Component Clinic/Center · Great Lakes, IL
Practice location
3350 Illinois St, Bldg 1523
Great Lakes, IL 60088-5230
Fax (847) 688-4430
Mailing address
3350 Illinois Street, Bldg 1523
Great Lakes, IL 60088-5230
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Outpatient Operational (Transportable) Component Clinic/Center Primary | 261QM1102X | None listed |
Military Outpatient Operational (Transportable) Component Clinic/Center: "Non-fixed" facilities or distinct parts of a "non-fixed" facility, providing outpatient medical and dental services, primarily intended for DoD active duty. The entity is funded with other than Defense Health Program funding. Non-DoD active duty may receive services from this entity. "Non-fixed" facilities are generally deployed DoD health care activities, not providing services on or in association with a DoD fort…
2 other providers at this address
About NPI 1093044281
Naval Health Clinic Great Lakes Illinois's National Provider Identifier is 1093044281, issued on Dec 17, 2009. The primary taxonomy on file is Military Outpatient Operational (Transportable) Component Clinic/Center (261QM1102X), and the practice location is in Great Lakes, IL. The record was last updated on Dec 17, 2009.