ProviderBusinessMailingAddressFaxNumber = '8479845676'
| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1801370457 | CANALES | HERNAN | D | | 3002 GRAND AVE | WAUKEGAN | IL | 600852321 |
| 1215317490 | GALLAS | BRIAN | ROBERT | | 3010 GRAND AVE | WAUKEGAN | IL | 600852321 |
| 1558994228 | GRIFFIN | ALMA | BERTHA | | 3002 GRAND AVE | WAUKEGAN | IL | 600852321 |
| 1881112712 | LASAK | NICOLE | | | 841 MOCKING BIRD DR | ANTIOCH | IL | 600022726 |
| 1184017360 | REYES | HERMINIA | | | 3010 GRAND AVE | WAUKEGAN | IL | 600852321 |
| 1629552724 | TELLO | VANESSA | ELLEN | | 3010 GRAND AVE | WAUKEGAN | IL | 600852321 |
| 1215461587 | VENHORST | SARA | K | | 3002 GRAND AVE | WAUKEGAN | IL | 600852321 |
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