Midwest Diagnostics Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

036074003 Issued in IL

Legal business name

MIDWEST DIAGNOSTICS INC

Practice address

3330 W 177TH St
Suite 2C
Hazel Crest, IL 60429-2184

Phone

(170) 879-9114

NPI assigned

Jan 23, 2008

Organization subpart

No

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

Authorized official

Name

Sandie Napientek

Title

Payer Contracting

Phone

(630) 399-5940

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242864000000",
    "number": "1932386760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 2C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "170-879-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 2C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "170-879-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "NAPIENTEK",
        "authorized_official_first_name": "SANDIE",
        "authorized_official_title_or_position": "PAYER CONTRACTING",
        "authorized_official_telephone_number": "630-399-5940"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "IL",
            "license": "036074003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01638865",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Physiological Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.