Long Term Care Laboratory, LLC.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

14D2026754 Issued in IL

Legal business name

LONG TERM CARE LABORATORY, LLC.

Practice address

2458 Elmhurst Rd
Elk Grove Village, IL 60007-6311

Phone

(630) 422-7800

Fax

(630) 422-1360

NPI assigned

Dec 6, 2011

Last updated

Aug 8, 2013By 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

Dr. Sam Shimi

Title

Adminstrator

Phone

(630) 422-7802

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1760750665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 ELMHURST RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600076311",
            "telephone_number": "630-422-7800",
            "fax_number": "630-422-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2458 ELMHURST RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600076311",
            "telephone_number": "630-422-7800",
            "fax_number": "630-422-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG TERM CARE LABORATORY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "SHIMI",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "630-422-7802",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D2026754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D2026754",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Marie Lindrum
• Christopher Lingat
• Diane Marie Lis, O.D.
• Najma Lokhandwala, M.D.
• Constance Reid Lokos, ADVANCE PRACTICE NUR
• Eugene P Lopez, M.D.
• Johanna M Lopez
• Nicole Lorang, NPP
• Erica Lorenz, ATC
• Jenise Lowe

• Clinical Medical Laboratory in Elk Grove Village, IL
• Providers in Elk Grove Village, 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 Aug 8, 2013; 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.