Northshore Clinical Laboratories Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NORTHSHORE CLINICAL LABORATORIES INC

Practice address

4751 N Kedzie Ave FL 1
Chicago, IL 60625-4420

Phone

(773) 570-6510

NPI assigned

Mar 27, 2007

Last updated

Oct 19, 2021By 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

Meena Mohindra

Title

Owner

Phone

(773) 570-6510

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1477671345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 N KEDZIE AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606254420",
            "telephone_number": "773-570-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 N KEDZIE AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606254420",
            "telephone_number": "773-570-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE CLINICAL LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "MOHINDRA",
        "authorized_official_first_name": "MEENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-570-6510"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "3580499",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001621417",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5847070",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Weiner Northrop, MA LCSW
• Tiffany Northrop, OTR/L M.A.
• Edward Nicholas Northrup, MD
• Northshore
• Northshore Center for Sleep Dentistry, LTD
• Northshore Health Partners LTD
• Northshore Home Health Corp.
• Northshore Imaging Company
• Northshore Medical Laboratory
• Northshore Medical Product Company

• 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 Oct 19, 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.