OAK CREST LABORATORY SERVICES, INC (NPI# 1205876554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205876554 |
| Entity Type | Organization |
| Organization Name | OAK CREST LABORATORY SERVICES, INC |
| Practice Address |
10522 S Cicero Ave 307 Oak Lawn IL 60453-5200 |
| Practice Telephone | 7084255359 |
| Practice Fax Number | 7084253047 |
| Mailing Telephone | 7084255359 |
| Mailing Fax Number | 7084253047 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2008-12-08 |
| Authorized Official Name | MR. MOHAMMAD YOUSEF KHALIFEH (LABORATORY MANAGER) |
| Authorized Official Telephone | 7084255359 |
| Authorized Official Credential | B.S.M.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 14D0418588 | IL | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ANTHEM BLUE CROSS PPO | 1205876554 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 1205876554 | 01 |
| Street Address |
10522 S CICERO AVE 307 |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-5200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567546 | Cynthia Lynn Rusnak | Nurse Practitioner | 10522 S Cicero Ave, Oak Lawn, IL 60453-5200 | 2020-08-04 |
| 1518406412 | Hillary Wildt | Psychologist | 10522 S Cicero Ave, Suite 401, Oak Lawn, IL 60453-5200 | 2017-02-13 |
| 1811349442 | Crossmont & Associates Inc | Counselor | 10522 S Cicero Ave, Suite 301-302, Oak Lawn, IL 60453-5200 | 2016-07-07 |
| 1245605831 | Lauren Elizabeth Oganovich | Psychologist | 10522 S Cicero Ave, Suite 401, Oak Lawn, IL 60453-5200 | 2015-12-08 |
| 1730577685 | Mirjam Quinn and Associates, Ltd | Psychologist | 10522 S Cicero Ave, Suite 305, Oak Lawn, IL 60453-5200 | 2014-12-30 |
| 1679913768 | Nisha Gokhale | Psychiatry & Neurology | 10522 S Cicero Ave, Ste 2d, Oak Lawn, IL 60453-5200 | 2013-07-03 |
| 1518221621 | Janhavi Desai | Psychologist | 10522 S Cicero Ave, Suite 305, Oak Lawn, IL 60453-5200 | 2012-07-03 |
| 1578852406 | Janet E. Costello | Counselor | 10522 S Cicero Ave, Suite 2d, Oak Lawn, IL 60453-5200 | 2011-03-31 |
| 1598079626 | Sunny Hill Personal Services, Inc. | In Home Supportive Care | 10522 S Cicero Ave, Oak Lawn, IL 60453-5200 | 2010-07-30 |
| 1265634521 | Debra Renee Horan | Social Worker | 10522 S Cicero Ave, 202, Oak Lawn, IL 60453-5200 | 2007-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558182 | Southwest Medical Solutions Inc | Clinical Medical Laboratory | 5533 W 109th St Ste 101, Oak Lawn, IL 60453-5058 | 2020-08-13 |
| 1245777051 | Heritage Lab Express Inc | Clinical Medical Laboratory | 5533 W 109th St Ste 220, Oak Lawn, IL 60453-2462 | 2017-01-31 |
| 1609880608 | Sleep Network of Illinois Inc | Clinical Medical Laboratory | 9642 S Pulaski Rd, Oak Lawn, IL 60453-3391 | 2006-07-28 |
| 1013411453 | Heritage Laboratory Inc | Clinical Medical Laboratory | 5533 W 109th St Ste 220, Oak Lawn, IL 60453-2462 | 2018-03-21 |
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| 1417573916 | Global Medical Solutionz Equipment & Transportation Co. | Clinical Medical Laboratory | 1334 Central Park Dr Ste 3, O Fallon, IL 62269-1784 | 2020-06-19 |
| 1538781174 | Harmone Labs, LLC | Clinical Medical Laboratory | 1622 S Taylorville Rd, Decatur, IL 62521-3951 | 2020-05-16 |
| 1225659204 | Gist Entities, LLC | Clinical Medical Laboratory | 11006 W 179th St, Orland Park, IL 60467-9440 | 2020-05-01 |
| 1477173847 | Augustus Labs LLC | Clinical Medical Laboratory | 2801 Finley Rd Ste 101, Downers Grove, IL 60515-1038 | 2020-04-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.