Centegra Clinical Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CENTEGRA CLINICAL LABORATORIES, LLC

Practice address

4201 W Medical Center Dr
McHenry, IL 60050-8409

Phone

(815) 759-4800

Fax

(815) 759-4565

NPI assigned

Sep 1, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Tomlinson

Title

Cio & Cfo

Phone

(815) 788-5831

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1013298108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-759-4800",
            "fax_number": "815-759-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTEGRA CLINICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "TOMLINSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CIO & CFO",
        "authorized_official_telephone_number": "815-788-5831"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Lee Caucig, LCPC, CRC
• Stan Cebrzynski, LCPC
• Courtney Rhiannon Cecille
• Eleonora C Cekova, M.D.
• Nilubol Cencula, RPH
• Centegra Health and Wellness Network
• Centegra Health System
• Centegra Primary Care LLC
• Center for Therapeutic Services & Psychodiagnostics
• James Cerbes

• Clinical Medical Laboratory in McHenry, IL
• Providers in McHenry, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.