Physicians Laboratory, LLC

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

PHYSICIANS LABORATORY, LLC

Practice address

1410 W Fulton St
Suite 204
Chicago, IL 60607-1110

Phone

(312) 262-4600

Fax

(312) 262-4531

NPI assigned

Jan 13, 2011

Organization subpart

No

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

Authorized official

Name

Mr. William Navas

Title

President

Phone

(312) 262-4600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1265737787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 W FULTON ST",
            "address_2": "SUITE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071110",
            "telephone_number": "312-262-4600",
            "fax_number": "312-262-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W FULTON ST",
            "address_2": "SUITE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071110",
            "telephone_number": "312-262-4600",
            "fax_number": "312-262-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "NAVAS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-262-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "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 Jan 13, 2011; 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.