Chicago PCR Lab Services Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CHICAGO PCR LAB SERVICES INC

Practice address

4176 W Montrose Ave Unit 105
Chicago, IL 60641-2161

Phone

(773) 263-4905

NPI assigned

Feb 25, 2022

Organization subpart

No

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

Authorized official

Name

Shakil Ghafoor

Title

President

Phone

(708) 831-8417

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1093461279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4176 W MONTROSE AVE UNIT 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412161",
            "telephone_number": "773-263-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4176 W MONTROSE AVE UNIT 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412161",
            "telephone_number": "773-263-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO PCR LAB SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "GHAFOOR",
        "authorized_official_first_name": "SHAKIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-831-8417"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.