Provider Demographics
NPI:1285017848
Name:FEDERAL HEALTH CARE CENTER
Entity Type:Organization
Organization Name:FEDERAL HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN, CHICAGO MEDICAL SCHOOL
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMKOWIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-578-3000
Mailing Address - Street 1:1235 S WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3001 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064
Practice Address - Country:US
Practice Address - Phone:847-688-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital