Active NPI
Woodlake Occupational Health LLC
Doing business as Woodlake Hospital LLC
- Occupational Medicine Clinic/Center
- Melrose Park, IL
National Provider Identifier
1104699032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Clinic/Center
- Legal business name
- WOODLAKE OCCUPATIONAL HEALTH LLC
- Doing business as
- Woodlake Hospital LLC
- Practice address
- 1111 Superior St Ste 506
Melrose Park, IL 60160-4156 - Phone
- (708) 919-9900
- NPI assigned
- Nov 2, 2023
- Last updated
- Nov 2, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chaim Rottenberg
- Title
- Asset Manager
- Phone
- (347) 522-5970
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Clinic/Center | 261QX0100X | Primary |
Addresses
Primary practice location
1111 Superior St Ste 506
Melrose Park, IL 60160-4156
Mailing address
150 Airport Rd Ste 900
Lakewood, NJ 08701-6988
Phone (516) 668-9675
Other names 1
- Woodlake Hospital LLC
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2246145 | Woodlake Occupational Health | Certificate of waiver | Dec 20, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698883200000",
"number": "1104699032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 AIRPORT RD STE 900",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087016988",
"telephone_number": "516-668-9675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 SUPERIOR ST STE 506",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601604156",
"telephone_number": "708-919-9900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODLAKE OCCUPATIONAL HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-02",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A",
"authorized_official_last_name": "ROTTENBERG",
"authorized_official_first_name": "CHAIM",
"authorized_official_title_or_position": "ASSET MANAGER",
"authorized_official_telephone_number": "347-522-5970"
},
"taxonomies": [
{
"code": "261QX0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Occupational Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Woodlake Hospital LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.