Medtech Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDTECH LAB LLC

Practice address

3706 Dempster St
Skokie, IL 60076-2232

Phone

(224) 260-7309

NPI assigned

Nov 22, 2021

Last updated

Feb 25, 2023By 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

Misbahuddin Khaja

Title

President

Phone

(224) 260-7309

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677283200000",
    "number": "1265199590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 DEMPSTER ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762232",
            "telephone_number": "224-260-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 DEMPSTER ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762232",
            "telephone_number": "224-260-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDTECH LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2023-02-25",
        "certification_date": "2023-02-25",
        "status": "A",
        "authorized_official_last_name": "KHAJA",
        "authorized_official_first_name": "MISBAHUDDIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-260-7309"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2023; 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.