Easy Lab Tech, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EASY LAB TECH, LLC

Practice address

2203 N Center St
Maryville, IL 62062-2024

Phone

(618) 772-7222

NPI assigned

Dec 24, 2021

Last updated

Dec 24, 2021By 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

Aigner Miles

Title

Business Operations Manager

Phone

(314) 562-6552

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1640304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640304000000",
    "number": "1093475527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 N CENTER ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620622024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 N CENTER ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620622024",
            "telephone_number": "618-772-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASY LAB TECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-24",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A",
        "authorized_official_last_name": "MILES",
        "authorized_official_first_name": "AIGNER",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS MANAGER",
        "authorized_official_telephone_number": "314-562-6552"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Dawn Duff, PA-C
• Jessica Erin Duft, RN
• Connie Ann Dumm, CRNA
• Darren Dunahee, MBA, MSW, LCSW
• Christina Ann Eaker, OT
• Koren Colleen Edwards, CCC-SLP
• Tracy Theresa Ehrhardt, LCPC, ATR-BC
• Claire Eller
• Jennifer Ellis, LCSW
• Elmwood Nursing & Rehabilitation Center, L.L.C.

• Clinic/Center in Maryville, IL
• Providers in Maryville, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; 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.