CMS Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

14D0950557 Issued in IL

Legal business name

CMS LABS INC

Practice address

1818 Skokie Blvd
Northbrook, IL 60062-4106

Phone

(847) 656-0194

Fax

(847) 714-1615

NPI assigned

Jul 18, 2005

Last updated

Dec 21, 2011By 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

Mr. Jamal Alwattar, M.S.

Title

President

Phone

(847) 480-4680

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1659370047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624106",
            "telephone_number": "847-656-0194",
            "fax_number": "847-714-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624106",
            "telephone_number": "847-656-0194",
            "fax_number": "847-714-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMS LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "ALWATTAR",
        "authorized_official_first_name": "JAMAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-480-4680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D1044289",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D1106803",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D0950557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031322000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "1636252",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amy Cochran, BCBA
• Elisabeth Coffel
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• Judy Lynn Cohan, LCSW
• Rachel Cohan

• Clinical Medical Laboratory in Northbrook, IL
• Providers in Northbrook, 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 Dec 21, 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.