Integrative Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INTEGRATIVE DIAGNOSTICS

Practice address

21237 S la Grange Rd Ste 5
Frankfort, IL 60423-2047

Phone

(779) 900-8389

Fax

(779) 204-3903

NPI assigned

Sep 21, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Rehan M Mohammed

Title

Owner/President

Phone

(872) 325-4332

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Malcolm Mandela Lee Sr., MD, MPH, CLS

  • Research Study Specialist
  • Chicago, IL
  • NPI 1659805521

  Clinical Medical Laboratory

  NPD (past)

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1841961778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21237 S LA GRANGE RD STE 5",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604232047",
            "telephone_number": "779-900-8389",
            "fax_number": "779-204-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21237 S LA GRANGE RD STE 5",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604232047",
            "telephone_number": "779-900-8389",
            "fax_number": "779-204-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "REHAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "872-325-4332",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.integrativediagnostics.us",
            "affiliation": "N",
            "address_1": "21237 S La Grange Rd Ste 5",
            "city": "Frankfort",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604232047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Medical Laboratory in Frankfort, IL
• Providers in Frankfort, 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 Sep 23, 2024; 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.