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:
Map and Directions
Authorized official contact:
Name: Balocki, John S Doctor of Osteopathy (DO)
Phone: (815) 455-0310

Health care specialties

SpecialtyCodeLicense #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 16 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1851353361 NPPES
Illinois MEDICAID 036073896

Popular Providers