Crystal Lake Family Treatment Center Ltd
LBN: Crystal Lake Family Treatment Center Ltd
Crystal Lake Family Treatment Center Ltd is an health care organization with primary practice located at 185 Heritage Drive Suite 3, Crystal Lake IL 60014. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Crystal Lake Family Treatment Center Ltd can be contacted via phone (815) 455-0310, or through Balocki, John S via phone (815) 455-0310.
Contact Information
Primary practice address
185 Heritage Drive Suite 3
Crystal Lake IL 60014
Phone: (815) 455-0310
Fax: (815) 455-1210
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036073896 | Illinois |
Profile Details
NPI number | 1851353361 |
---|---|
LBN Legal business name | Crystal Lake Family Treatment Center Ltd |
DBA Doing business as | |
Authorized official | Balocki, John S Doctor of Osteopathy (DO) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Apr 3rd, 2006 |
Last updated | Nov 12th, 2010 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1851353361 | NPPES |
Illinois | MEDICAID | 036073896 |
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