Organization Active NPI

Reditus Laboratories

  • Anatomic Pathology & Clinical Pathology Physician
  • Pekin, IL
National Provider Identifier
1770131831
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
REDITUS LABORATORIES
Practice address
200 Enterprise Dr
Pekin, IL 61554-9310
Phone
(469) 498-0222
Fax
(469) 498-0223
NPI assigned
Aug 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Thomas Hidder
Title
Cfo
Phone
(312) 890-6384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

200 Enterprise Dr
Pekin, IL 61554-9310

Mailing address

200 Enterprise Dr
Pekin, IL 61554-9310
Phone (469) 498-0222

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1770131831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ENTERPRISE DR",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615549310",
            "telephone_number": "469-498-0222",
            "fax_number": "469-498-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ENTERPRISE DR",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615549310",
            "telephone_number": "469-498-0222",
            "fax_number": "469-498-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDITUS LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "HIDDER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-890-6384"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.