Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Surgeons of Lake County LLC

Organization Surgery Physician · NPI 1417145301

Surgeons of Lake County LLC provides Surgery Physician services 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 Not confirmed with CMS for 17 years — call before visiting
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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