Lifescan Labs of Illinois, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LIFESCAN LABS OF ILLINOIS, LLC

Practice address

5255 Golf Rd
Skokie, IL 60077-1106

Phone

(847) 663-8300

Fax

(847) 663-1977

NPI assigned

Mar 1, 2019

Organization subpart

No

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

Authorized official

Name

Eliyahu Kutoff

Title

Ceo

Phone

(847) 663-8300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1922565506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9855 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771127",
            "telephone_number": "847-663-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 GOLF RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771106",
            "telephone_number": "847-663-8300",
            "fax_number": "847-663-1977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9775 Rockside Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441256266",
            "country_code": "US",
            "telephone_number": "847-663-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124173",
            "country_code": "US",
            "telephone_number": "847-663-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFESCAN LABS OF ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-01",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "KUTOFF",
        "authorized_official_first_name": "ELIYAHU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-663-8300"
    },
    "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 Skokie, IL
• Providers in Skokie, 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 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.