Nisa Estates LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NISA ESTATES LLC

Practice address

5757 N Lincoln Ave Ste 19
Chicago, IL 60659-4729

Phone

(773) 817-7965

NPI assigned

Jan 4, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Choudhry I Tarar

Title

Owner

Phone

(773) 817-7965

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1811658644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 N LINCOLN AVE STE 19",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594729",
            "telephone_number": "773-817-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 N LINCOLN AVE STE 19",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594729",
            "telephone_number": "773-817-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISA ESTATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "TARAR",
        "authorized_official_first_name": "CHOUDHRY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-817-7965",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.