NPIMap

Organization Active NPI

Retired From Rush Univ. Med Center

  • Clinical Medical Laboratory
  • Oak Brook, IL
National Provider Identifier
1114274016
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
036059548 Issued in IL
Legal business name
RETIRED FROM RUSH UNIV. MED CENTER
Practice address
16 Forest Gate Cir
Oak Brook, IL 60523-2129
Phone
(630) 572-9202
Fax
(630) 572-9765
NPI assigned
Aug 9, 2012
Last updated
Aug 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Authorized official

Name
Dr. Paul Wong, MD
Title
Professor, Director of Genetics
Phone
(312) 942-6298

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 036059548 IL Primary

Addresses

Primary practice location

16 Forest Gate Cir
Oak Brook, IL 60523-2129

Mailing address

16 Forest Gate Cir
Oak Brook, IL 60523-2129
Phone (630) 572-9202

National Provider Directory

National Provider Directory
Tax ID family
Invalid Entry19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1114274016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FOREST GATE CIR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232129",
            "telephone_number": "630-572-9202",
            "fax_number": "630-572-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FOREST GATE CIR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232129",
            "telephone_number": "630-572-9202",
            "fax_number": "630-572-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETIRED FROM RUSH UNIV. MED CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PROFESSOR, DIRECTOR OF GENETICS",
        "authorized_official_telephone_number": "312-942-6298",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "036059548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.