Justice Med Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

14D0982127 Issued in IL

Legal business name

JUSTICE MED LAB

Practice address

9050 W 81St St
Justice, IL 60458-1350

Phone

(708) 594-3500

Fax

(708) 594-5171

NPI assigned

Jan 18, 2007

Last updated

Sep 30, 2008By 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

Theodore Christou, MD

Title

Manager

Phone

(708) 563-0330

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Vijay Gupta, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Munster, IN
  • NPI 1740289313
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1336291236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 W 81ST ST",
            "city": "JUSTICE",
            "state": "IL",
            "postal_code": "604581350",
            "telephone_number": "708-594-3500",
            "fax_number": "708-594-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 W 81ST ST",
            "city": "JUSTICE",
            "state": "IL",
            "postal_code": "604581350",
            "telephone_number": "708-594-3500",
            "fax_number": "708-594-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTICE MED LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "CHRISTOU",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-563-0330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D0982127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01629953",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kijuana Hooper
• Indian Springs SCH Dist 109
• James a. Gianfrancisco MD LTD
• Tricia G James, LCSW
• Megan Jurgel, RDN
• Justice Med-Lab
• Samrah Kelly
• Cheng H Lin
• Madhavi Gadde DMD LTD
• Subhan Manzoor, DDS

• Clinical Medical Laboratory in Justice, IL
• Providers in Justice, 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 Sep 30, 2008; 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.