Histology Corp

Primary specialty

Histology TechnicianTaxonomy code 246RH0600X

Legal business name

HISTOLOGY CORP

Practice address

21 N Skokie Hwy
Suite 202
Lake Bluff, IL 60044-1777

Phone

(847) 525-3147

NPI assigned

Sep 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Daniel J Kelly, M.D.

Title

President

Phone

(847) 525-3147

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1043469745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 N SKOKIE HWY",
            "address_2": "SUITE 202",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441777",
            "telephone_number": "847-525-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N SKOKIE HWY",
            "address_2": "SUITE 202",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441777",
            "telephone_number": "847-525-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HISTOLOGY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-525-3147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "246RH0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Histology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Histology Technician in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Histology Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.