Active NPI
Carol Ann Nufer
- Clinical Laboratory Director (Non-physician)
- Forest Park, IL
National Provider Identifier
1912193079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Laboratory Director (Non-physician)
- License
- MT-170462
- Practice address
- 7211 Jackson Blvd
#2
Forest Park, IL 60130-3247 - Phone
- (708) 488-1453
- NPI assigned
- Sep 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Laboratory Director (Non-physician) | 247ZC0005X | MT-170462 | IL | Primary |
Addresses
Primary practice location
7211 Jackson Blvd
#2
Forest Park, IL 60130-3247
Mailing address
7211 Jackson Blvd
#2
Forest Park, IL 60130-3247
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT-170462 | IL | MD | Clinical Laboratory Director (Non-physician) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190332800000",
"number": "1912193079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7211 JACKSON BLVD",
"address_2": "#2",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601303247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7211 JACKSON BLVD",
"address_2": "#2",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601303247",
"telephone_number": "708-488-1453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUFER",
"first_name": "CAROL",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-21",
"last_updated": "2007-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "247ZC0005X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
"state": "IL",
"license": "MT-170462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.