Whalio Doctors

NPI 1174709810

Independence Center, INC.

Organisation Community/Behavioral Health Agency Waukegan, IL

Practice location

Address
2025 Washington St, Waukegan, IL 60085-5131
Phone
(847) 360-1020
Fax
(847) 360-1065

Authorised official

Name
Lisa Johnson
Title
Executive Director
Phone
(847) 360-1020

Registered specialties (5)

Community/Behavioral Health Agency Primary
Agencies Taxonomy 251S00000X
Case Management Agency
Agencies Taxonomy 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center)
Ambulatory Health Care Facilities Taxonomy 261QM0801X
Adult Mental Health Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QM0850X
Mental Illness Community Based Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320800000X

Registry record

NPI
1174709810
Entity type
Organization
NPI issued
11 Jan 2008
Record last updated
4 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.