Lifequest Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LIFEQUEST DIAGNOSTICS LLC

Practice address

3425 W Peterson Ave Ste 102
Chicago, IL 60659-3443

Phone

(773) 615-0279

NPI assigned

Oct 8, 2024

Last updated

Jul 18, 2025By 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

Rukshana Salim

Title

President

Phone

(773) 615-0279

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1235958182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 W PETERSON AVE STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593443",
            "telephone_number": "773-615-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 W PETERSON AVE STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593443",
            "telephone_number": "773-615-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEQUEST DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "SALIM",
        "authorized_official_first_name": "RUKSHANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-615-0279"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.