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FAMILY CARE OF LAKE COUNTY S.C.
NPI 1861485658
Family Medicine in Lake Villa, IL

Active since August 26, 2005CLIA 14D0871804 · Waiver
500 PARK AVE, STE 104, LAKE VILLA, IL 60046(847) 245-8700(847) 245-8771 Get Directions Write a Review

NPPES record last updated: December 23, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 23, 2021, Dec 10, 2021, Dec 2, 2021 (3 updates tracked since 2021).

About Family Care Of Lake County S.c. NPPES

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

FAMILY CARE OF LAKE COUNTY S.C. (NPI 1861485658) is a healthcare organization registered as a family medicine in Lake Villa, Illinois and active in the NPI registry since August 2005. The organization holds a CLIA Waiver certificate valid through November 9, 2027 and lists Eugene Pomeranets, Owner/md, as its authorized official.

NPPES Registry Identity

NPI1861485658
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAMILY CARE OF LAKE COUNTY S.C.
Location Address500 PARK AVE, STE 104Lake Villa, IL 60046-6556
Mailing Address500 Park Ave, Ste 104Lake Villa, IL 60046-6556 · (847) 245-8700 · Fax (847) 245-8771
Phone(847) 245-8700
Fax(847) 245-8771
Organization SubpartNo
Authorized OfficialEugene PomeranetsOwner/md · (847) 245-8700
Enumeration DateAugust 26, 2005
Last NPPES UpdateDecember 23, 20213 updates tracked since enumeration
NPPES CertifiedDecember 23, 2021
✔ NPI 1861485658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
500 PARK AVE, Lake Villa, IL 60046
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Family Care Of Lake County S.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Family Care Of Lake County S.C., which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Semyon Maslovsky, MD
Family Practice
NPI 1508855040
500 PARK AVE STE 104
Lake Villa, IL 60046
(847) 245-8700
✔ PECOSSame address
Eugene Pomeranets, MD
Family Practice
NPI 1770579005
500 PARK AVE STE 104
Lake Villa, IL 60046
(847) 245-8700
✔ PECOS✔ Accepts MedicareSame address
Jill Zupansic, APN, FNP-BC
Nurse Practitioner
NPI 1346810488
500 PARK AVE STE 104
Lake Villa, IL 60046
(847) 245-8700
✔ PECOS5.9 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0871804

Family Care Of Lake County · Lake Villa, IL
Active · expires Nov 9, 2027
CLIA Number14D0871804
Laboratory TypePhysician Office
Certificate Effective DateNovember 10, 2025
Certificate Expiration DateNovember 9, 2027
Laboratory DirectorSemyon Maslovsky MD
Laboratory Phone(847) 245-8700
Laboratory LocationFamily Care Of Lake County500 Park Avenue, Ste 104, Lake Villa, IL 60046
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Family Care Of Lake County S.C.'s NPI number?

The NPI number for Family Care Of Lake County S.C. is 1861485658. It was assigned to this organization in the NPPES registry on August 26, 2005.

Where is Family Care Of Lake County S.C. located?

Family Care Of Lake County S.C. is located at 500 Park Ave Ste 104, Lake Villa, IL 60046. The listed phone number is (847) 245-8700.

What is Family Care Of Lake County S.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Family Care Of Lake County S.C. enrolled in Medicare?

Yes. Family Care Of Lake County S.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Family Care Of Lake County S.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Family Care Of Lake County S.C., in Family Practice and Nurse Practitioner. 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. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Family Care Of Lake County S.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0871804) is associated with this NPI, valid through November 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Family Care Of Lake County S.C. was last updated on December 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.