Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Surgeons of Lake County LLC

Organization Surgery Physician · NPI 1417145301

Surgeons of Lake County LLC is a Surgery Physician in Libertyville, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1870 W Winchester Rd Ste 112
Libertyville, IL 60048-5358
Phone: (847) 816-7495
Fax: (847) 816-7497
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 036109065 (IL)

Record details

NPI number1417145301
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Scott Otto — President · (847) 816-7495
NPI enumeratedOctober 4, 2007
Last updated in NPPESOctober 1, 2009
Mailing address1870 W Winchester Rd, Suite 112, Libertyville, IL 60048-5358

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