Advance Medical Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ADVANCE MEDICAL LAB

Practice address

1793 Bloomingdale Rd
Glendale Heights, IL 60139-3800

Phone

(630) 373-4545

Fax

(630) 933-9371

NPI assigned

Sep 16, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mohammed M Ahmed

Title

Owner

Phone

(630) 373-4545

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083710024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1793 BLOOMINGDALE RD",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601393800",
            "telephone_number": "630-373-4545",
            "fax_number": "630-933-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1793 BLOOMINGDALE RD",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601393800",
            "telephone_number": "630-373-4545",
            "fax_number": "630-933-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MEDICAL LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-373-4545",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Glendale Heights, IL
• Providers in Glendale Heights, 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 Aug 22, 2020; 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.