South Chicago Lab Limited

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

Legal business name

SOUTH CHICAGO LAB LIMITED

Practice address

8058 S Western Ave
Chicago, IL 60620-5936

Phone

(815) 440-9285

NPI assigned

May 21, 2021

Organization subpart

No

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

Authorized official

Name

Steven Abu-Shaqra, PHD

Title

President

Phone

(815) 440-9285

Specialties & licenses 1

Addresses

Other names 2

• SOUTH CHICAGO LAB L LIMITED Former legal business name
• SOUTH CHICAGO LAB LIMITED Former legal business name

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1215502349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 S 84TH AVE",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651302",
            "telephone_number": "815-440-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8058 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205936",
            "telephone_number": "815-440-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CHICAGO LAB LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "ABU-SHAQRA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-440-9285",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH CHICAGO LAB L LIMITED",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "SOUTH CHICAGO LAB LIMITED",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jacqueline Rose Souter, AU.D.
• South Central Community Services, Inc.
• South Central Community Services, Inc.
• South Central Community Services, Inc.
• South Chicago Foot & Ankle Center, LTD
• South Chicago Orthopedic Specialists, SC
• South Chicago Parents and Friends, Inc.
• South Chicago Physicial Medicine
• South Chicago Sleep Lab, Inc.
• South Chicago SLF, LLC

• Clinical Pathology/Laboratory Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Pathology/Laboratory Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.