Individual provider Active NPI

Yarlesha Johnson, PHLEBOTOMIST

  • Clinical Laboratory Director (Non-physician)
  • Chicago, IL
National Provider Identifier
1407502453
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
License
T3J8H7X2 Issued in IL
Practice address
1 E Erie St Ste 525
Chicago, IL 60611-2980
Phone
(847) 236-2219
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X T3J8H7X2 IL
Clinical Laboratory Director (Non-physician) 247ZC0005X T3J8H7X2 IL Primary

Addresses

Primary practice location

1 E Erie St Ste 525
Chicago, IL 60611-2980

Mailing address

8518 S Saint Lawrence Ave
Chicago, IL 60619-6025
Phone (312) 286-1160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T3J8H7X2ILMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Perfection CurrentSince Mar 20, 2022 Accepting new patients

Locations

1 E Erie St
Ste 525
Chicago, IL 60611
Phone (312) 775-2045

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1407502453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8518 S SAINT LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196025",
            "telephone_number": "312-286-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 525",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112980",
            "telephone_number": "847-236-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "YARLESHA",
        "credential": "PHLEBOTOMIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "IL",
            "license": "T3J8H7X2",
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "IL",
            "license": "T3J8H7X2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.