Ollae Medical Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OLLAE MEDICAL LABORATORY

Practice address

1809 Home Ave
Berwyn, IL 60402-1669

Phone

(708) 692-5499

NPI assigned

Oct 28, 2007

Last updated

Mar 14, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

OLLAE MEDICAL LABAs reported in NPPES

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

Authorized official

Name

Mrs. Onesimo Flores, OWNER

Title

Medical Lab

Phone

(708) 692-5499

Specialties & licenses 1

Addresses

Other names 1

• OLLAE MEDICAL LABORATORY Other name

Part of

Ollae Laboratory Inc

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

{
    "created_epoch": "1193529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300060800000",
    "number": "1528247459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 HOME AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021669",
            "telephone_number": "708-692-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 HOME AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021669",
            "telephone_number": "708-692-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLLAE MEDICAL LABORATORY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLLAE MEDICAL LAB",
        "enumeration_date": "2007-10-28",
        "last_updated": "2011-03-14",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "ONESIMO",
        "authorized_official_title_or_position": "MEDICAL LAB",
        "authorized_official_telephone_number": "708-692-5499",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLLAE MEDICAL LABORATORY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Oladimeji Ogbara, D.D.S
• Rebecca Annette Ogle
• Carrie Elizabeth Ohl, L.C.S.W
• Josshy Olea
• Olga a Mendez DDS and Associates
• Omar Souman, DMD, P.C.
• Michael Onak, LSW
• Oncology Management Sytems,LLC
• Samuel Oo, DO
• Rosa Elida Ordaz, INTERPRETER/TRANSLAT

• Clinical Medical Laboratory in Berwyn, IL
• Providers in Berwyn, 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 Mar 14, 2011; 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.