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LAKE IMMEDIATE CARE & CLINIC S C
NPI 1114208642
Internal Medicine in Island Lake, IL

Active since August 29, 2011
452 W STATE RD STE D, ISLAND LAKE, IL 60042(847) 519-1061 Get Directions Write a Review

NPPES record last updated: October 27, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lake Immediate Care & Clinic S C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE IMMEDIATE CARE & CLINIC S C (NPI 1114208642) is a healthcare organization registered as an internal medicine in Island Lake, Illinois and active in the NPI registry since August 2011. The organization lists Eberechukwu Ibe, President, as its authorized official.

NPPES Registry Identity

NPI1114208642
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLAKE IMMEDIATE CARE & CLINIC S C
Location Address452 W STATE RD STE DIsland Lake, IL 60042-8438
Mailing Address452 W State Rd Ste DIsland Lake, IL 60042-8438 · (847) 519-1061
Phone(847) 519-1061
Organization SubpartNo
Authorized OfficialEberechukwu IbePresident · (708) 606-7219
Enumeration DateAugust 29, 2011
Last NPPES UpdateOctober 27, 2011
✔ NPI 1114208642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036107391
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 036113328 (IL)
452 W STATE RD STE D, Island Lake, IL 60042
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lake Immediate Care & Clinic S C is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Lake Immediate Care & Clinic S C, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Eberechukwu Ibe, MD
Internal Medicine
NPI 1841258043
1701 W MONTEREY AVE
Chicago, IL 60643
(773) 445-0292
✔ PECOS✔ Accepts Medicare49 mi
Reginald Ebirim, M.D.
Family Practice
NPI 1396702957
1405 MILL ST
New London, WI 54961
(920) 531-2000
✔ PECOS✔ Accepts Medicare147 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Immediate Care & Clinic S C's NPI number?

The NPI number for Lake Immediate Care & Clinic S C is 1114208642. It was assigned to this organization in the NPPES registry on August 29, 2011.

Where is Lake Immediate Care & Clinic S C located?

Lake Immediate Care & Clinic S C is located at 452 W State Rd Ste D, Island Lake, IL 60042. The listed phone number is (847) 519-1061.

What is Lake Immediate Care & Clinic S C's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Lake Immediate Care & Clinic S C enrolled in Medicare?

Yes. Lake Immediate Care & Clinic S C is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Immediate Care & Clinic S C?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Lake Immediate Care & Clinic S C, in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lake Immediate Care & Clinic S C accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Lake Immediate Care & Clinic S C as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Immediate Care & Clinic S C was last updated on October 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.