Northshore Medical Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NORTHSHORE MEDICAL LABORATORY

Practice address

1743 E 87TH St
Chicago, IL 60617-2741

Phone

(773) 734-8998

Fax

(773) 375-8999

NPI assigned

Dec 29, 2023

Last updated

Nov 20, 2024By 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

Mr. Felix ParkerNPI 1356738900

Title

Administrator/Owner

Phone

(312) 973-2395

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Felix Parker

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1356738900
  NPD Authorized official

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1275302374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 E 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172741",
            "telephone_number": "312-973-2395",
            "fax_number": "773-375-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 E 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172741",
            "telephone_number": "773-734-8998",
            "fax_number": "773-375-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE MEDICAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-29",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "FELIX",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "312-973-2395",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northshore Imaging Company
• Northshore Medical Product Company
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• Northshore Pediatrics Associates,S.C.
• Northshore Physicians LTD.
• Northside Center for Relationship Counseling

• 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 Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.