Watertower Lab Serives LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

036066567 Issued in IL

Legal business name

WATERTOWER LAB SERIVES LLC

Practice address

845 N Michigan Ave
Suite 930E
Chicago, IL 60611-2252

Phone

(312) 654-2154

Fax

(312) 867-7841

NPI assigned

Sep 24, 2008

Last updated

Sep 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Tammy Timm

Title

Director of Operations

Phone

(312) 654-2154

Specialties & licenses 1

Addresses

Tax ID family

Watertower Lab Serives LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Watertower Lab Services LLC

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1215193610
  NPD tax ID

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1932359122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N MICHIGAN AVE",
            "address_2": "SUITE 930E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112252",
            "telephone_number": "312-654-2154",
            "fax_number": "312-867-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N MICHIGAN AVE",
            "address_2": "SUITE 930E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112252",
            "telephone_number": "312-654-2154",
            "fax_number": "312-867-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWER LAB SERIVES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "TIMM",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "312-654-2154",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "IL",
            "license": "036066567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tashauna Waters
• Theresa Latisha Waters
• Watertower Associates
• Watertower Clinic Associates
• Watertower Clinic Associates LTD
• Watertower Lab Services LLC
• Alanna Marie Dyko Wathen, DPT
• Sarah Cunningham Watkin, LCSW
• Alexandra Watkins, LAC, MSTOM
• Anaiya Watkins

• Radiology Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Radiology Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.