Stat Mobile Phlebotomy LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

STAT MOBILE PHLEBOTOMY LLC

Practice address

1700 N Berwick Blvd Apt K212
Waukegan, IL 60085-1578

Phone

(312) 508-0530

Fax

(872) 813-5255

NPI assigned

Feb 28, 2021

Organization subpart

No

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

Authorized official

Name

Miss Heatherkay Elliott, MA

Title

Manager

Phone

(312) 508-0530

Specialties & licenses 2

Addresses

Other names 1

• Stat Mobile Phlebotomy and Laboratory LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1614470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1659965887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 7TH ST APT 102",
            "city": "PARK CITY",
            "state": "IL",
            "postal_code": "600856985",
            "telephone_number": "872-813-4712",
            "fax_number": "872-813-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N BERWICK BLVD APT K212",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600851578",
            "telephone_number": "312-508-0530",
            "fax_number": "872-813-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT MOBILE PHLEBOTOMY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-28",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "HEATHERKAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "312-508-0530",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stat Mobile Phlebotomy and Laboratory LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer C Stallings, CNA
• Dawn Stancel
• Dragana Stanic, RN
• Jennifer Melissa Starzec, M.A. CF-SLP
• Susan Stasek, PSYCHOLOGIST
• Steele Medical Supply Co.
• Angie Stefani
• John Raymond Steffes, CCC-SLP
• Jennifer Stegmeier
• Patricia Steinbach

• Clinical Medical Laboratory in Waukegan, IL
• Providers in Waukegan, 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 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.