Organization Active NPI

Casillo Enterprises LLC

  • Clinical Medical Laboratory
  • Chicago, IL
National Provider Identifier
1639836729
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CASILLO ENTERPRISES LLC
Practice address
4924 W Deming PL
Chicago, IL 60639-2521
Phone
(312) 868-7166
NPI assigned
Nov 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Brian Lerner
Title
President
Phone
(312) 868-7166

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Clinical Medical Laboratory 291U00000X Primary
Pharmacy 333600000X

Addresses

Primary practice location

4924 W Deming PL
Chicago, IL 60639-2521

Mailing address

4924 W Deming PL
Chicago, IL 60639-2521
Phone (312) 868-7166

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1639836729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 W DEMING PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392521",
            "telephone_number": "312-868-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 W DEMING PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392521",
            "telephone_number": "312-868-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASILLO ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "LERNER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-868-7166"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 14, 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.