Optimum Faith Lab Corp

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OPTIMUM FAITH LAB CORP

Practice address

1360 N Green Bay Rd
Waukegan, IL 60085-1104

Phone

(224) 610-0434

Fax

(855) 325-1872

NPI assigned

Nov 15, 2016

Last updated

Dec 10, 2020By 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

Mrs. Opal Mullings

Title

Manager

Phone

(224) 610-0434

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Optimum Faith Lab Corp

  • Nursing Facility Supplies (DME)
  • Waukegan, IL
  • NPI 1952922908
  NPPES parent name

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1245772748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600851104",
            "telephone_number": "224-610-0434",
            "fax_number": "855-325-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600851104",
            "telephone_number": "224-610-0434",
            "fax_number": "855-325-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM FAITH LAB CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "MULLINGS",
        "authorized_official_first_name": "OPAL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "224-610-0434",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olutoyin Okunfolami, WHNP
• Stephanie Olivar
• Bukola Jumoke Omotowon
• One Hope United
• Debra L Oneil, RN
• Optimum Faith Lab Corp
• Patricia Orellana
• Julyannie Orellano-Rodriguez
• Leila Pearl Ortega, RN
• Orthodontic Experts LTD

• Clinical Medical Laboratory in Waukegan, IL
• Providers in Waukegan, 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 Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.