Parkside Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PARKSIDE LABORATORY LLC

Practice address

405 N Wabash Ave Ste P2C
Chicago, IL 60611-3584

Phone

(312) 955-4005

NPI assigned

Jun 10, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Mona Khan, DO

Title

Owner

Phone

(312) 998-5229

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1265161541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE STE P2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113584",
            "telephone_number": "312-955-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE STE P2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113584",
            "telephone_number": "312-955-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-998-5229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Stephanie Parks, MSOT
• Tanya M Parks, O.D.
• Taylor Parks, OTR/L
• Taylor Beth Parks, LSW, MSW
• Parkshore Estates Nursing and Rehabiliation Center LLC
• Parkside Therapy
• Parkview Dental Care
• Parkwest Family Practice SC
• Parkwest Podiatry, P.C.
• Parkwest Podiatry, P.C.

• 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 Jun 10, 2022; 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.