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

The Illinois Medical Assistance Treatment Program LLC

Organization Clinic/Center · NPI 1407008998

The Illinois Medical Assistance Treatment Program LLC is a Clinic/Center in Waukegan, Illinois. Licensed in Illinois. Registered with an NPI since 2008.

Licensed in
IL
In the registry since
2008
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

1738 Washington St
Waukegan, IL 60085-5137
Phone: (847) 360-1019
Fax: (847) 360-6277
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence A27740001A (IL)

Record details

NPI number1407008998
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Keller — Medical Director · (847) 360-1019
Other names Green Dragonfly
NPI enumeratedOctober 16, 2008
Last updated in NPPESOctober 16, 2008
Mailing address1738 Washington St, Waukegan, IL 60085-5137

Other providers in Waukegan