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CH05887D COUNTY OF LAKE (Active)
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Main Details
Name
COUNTY OF LAKE
Subdivision Name
Belvidere Medical Building
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001280
340B ID
CH05887D
Grant Number
H80CS00119
Additional Details
Current Program Status
Active
Registration Date
7/1/2001
Participating Start Date
7/1/2001
Participating Approval Date
12/7/2004
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
County of Lake
Chris Hoff, Executive Director
(847) 377-8327
Primary Contact
Lake County Health Department
Angela L Smith, Clinical Compliance Manager
(847) 377-8346
Addresses
Street Address
2400 Belvidere Rd
Waukegan, IL 60085-6165
Billing Address
Lake County Health Department and Community Health Center
3010 Grand Avenue
3rd Floor
Waukegan, IL 60085
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/7/04 UPDATED ENTITY NAME; 12/7/04 REMOVED MEDICAID #; 12/7/04 ADDED BILL TO
06/11/2010
April 2025
April 2025
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