Elgin Lab Diagnostic LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ELGIN LAB DIAGNOSTIC LLC

Practice address

229 W Grand Ave Ste R
Bensenville, IL 60106-3365

Phone

(708) 581-8304

Fax

(877) 389-7885

NPI assigned

Jan 25, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Muhammad Nazir, ADMINISTRATOR

Title

Administrator

Phone

(708) 581-8304

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1790437366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 N ARTESIAN AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606226962",
            "telephone_number": "206-234-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W GRAND AVE STE R",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601063365",
            "telephone_number": "708-581-8304",
            "fax_number": "877-389-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN LAB DIAGNOSTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "NAZIR",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-581-8304",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@elginlab.com",
            "affiliation": "N",
            "endpointDescription": "EMail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMAIL",
            "address_1": "229 W Grand Ave Ste R",
            "city": "Bensenville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601063365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Medical Laboratory in Bensenville, IL
• Providers in Bensenville, 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 Jan 25, 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.