Test Liberty Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TEST LIBERTY INC

Practice address

2247 W Devon Ave
Chicago, IL 60659-2284

Phone

(833) 542-8378

NPI assigned

Mar 10, 2022

Organization subpart

No

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

Authorized official

Name

Mukram Shaik

Title

President

Phone

(574) 204-3022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1851049779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8241 LOWELL AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762623",
            "telephone_number": "833-542-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2247 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606592284",
            "telephone_number": "833-542-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEST LIBERTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "SHAIK",
        "authorized_official_first_name": "MUKRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-204-3022"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frazer Tessema, MD
• Jessica Rose Tessendorf, PA-C
• Aliza Tessler
• Karen Tessler, PH.D.
• Dorothy Clare Tessman
• Fernando D Testai, MD, PHD
• Semaj Nikia Testamark, MD
• Caroline J Teter, PA-C
• Elizabeth S Tetteh, M.D.
• Shannon L. Tetteh

• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, 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 1, 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.