Doctors Clinical Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1167724 Issued in IL

Legal business name

DOCTORS CLINICAL LABORATORY INC

Practice address

1685 Winnetka Cir
Rolling Meadows, IL 60008-1372

Phone

(312) 448-8570

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Mohammed Shujauddin

Title

President

Phone

(312) 448-8570

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1285758581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 N LINCOLN AVE # 348",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606592313",
            "telephone_number": "312-448-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 WINNETKA CIR",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600081372",
            "telephone_number": "312-448-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS CLINICAL LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "SHUJAUDDIN",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-448-8570"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "1167724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELDS",
            "identifier": "01630245",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy Corpuz Del Mundo, LMT
• Alyssa Demos
• Caitlin Nicole Dempsey, OTD, OTR/L
• Diagnostic Radiology Network
• Diana M. Rothermel, Psy.D., PLLC
• Doctors on Call Incorporated
• Dr Wang DMD PC
• Abigail Dunford
• Betsy Dunlop, PHARMD
• Sandy Eder, LCPC

• Clinical Medical Laboratory in Rolling Meadows, IL
• Providers in Rolling Meadows, 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 Oct 1, 2021; 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.