Wazeen Abuawad, LAB DIRECTOR

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

Practice address

6117 W 79TH PL
Burbank, IL 60459-1901

Phone

(708) 682-2234

NPI assigned

Feb 10, 2022

Last updated

Feb 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holy Land Labs LLC

  • Clinical Medical Laboratory
  • Burbank, IL
  • NPI 1467107938
  NPD Authorized official

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1699429316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6117 W 79TH PL",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591901",
            "telephone_number": "708-682-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6117 W 79TH PL",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591901",
            "telephone_number": "708-682-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUAWAD",
        "first_name": "WAZEEN",
        "credential": "LAB DIRECTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 9 & Grey PLLC
• Sami M Abdelrahim, DMD
• Bara M Abusharara, DMD
• Eman Abutaleb
• Lamis Abutaleb
• Adams Family Dental
• Marie Adu, D.P.T.

• Clinical Laboratory Director (Non-physician) in Burbank, IL
• Providers in Burbank, IL by specialty
• Clinical Laboratory Director (Non-physician) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.