United Eg LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

UNITED EG LLC

Doing business as

Life Long Labs

Practice address

616 E Roosevelt Rd
Lombard, IL 60148-4741

Phone

(630) 445-1109

NPI assigned

Oct 5, 2021

Last updated

Aug 16, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

UNITED EG LLCAs reported in NPPES

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

Authorized official

Name

Abdul Ansar Ahmed Mohammed

Title

President

Phone

(630) 445-1109

Specialties & licenses 1

Addresses

Other names 1

• Life Long Labs Doing business as

Part of

United Eg LLC

Locations

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1295407468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484741",
            "telephone_number": "630-445-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484741",
            "telephone_number": "630-445-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED EG LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITED EG LLC",
        "enumeration_date": "2021-10-05",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "ABDUL ANSAR AHMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-445-1109"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Long Labs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life Long Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Lombard, IL
• Providers in Lombard, 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 Aug 16, 2024; 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.