Westchester Diagnostic Laboratory

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

WESTCHESTER DIAGNOSTIC LABORATORY

Practice address

2225 Enterprise Dr
Suite 2511
Westchester, IL 60154-5814

Phone

(708) 486-0076

Fax

(708) 486-0080

NPI assigned

Nov 27, 2007

Organization subpart

No

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

Authorized official

Name

George G Moran, MD

Title

President

Phone

(708) 492-0502

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1750563219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3183 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740031",
            "telephone_number": "708-492-0502",
            "fax_number": "708-492-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 ENTERPRISE DR",
            "address_2": "SUITE 2511",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545814",
            "telephone_number": "708-486-0076",
            "fax_number": "708-486-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTCHESTER DIAGNOSTIC LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-492-0502",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Westchester Eye Surgeons, S.C.
• Westchester Family Dental LTD
• Westchester Integrated Health Care SC
• Westchester Integrated Health Services
• Westchester Olympic Service Corp

• Anatomic Pathology & Clinical Pathology Physician in Westchester, IL
• Providers in Westchester, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.