OPTIMUM FAITH LAB CORP (NPI# 1952922908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952922908 |
| Entity Type | Organization |
| Organization Name | OPTIMUM FAITH LAB CORP |
| Practice Address |
1109 Washington St Waukegan IL 60085-5301 |
| Practice Telephone | 2246100434 |
| Practice Fax Number | 8553251872 |
| Mailing Telephone | 2246100434 |
| Mailing Fax Number | 8553251872 |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-04-30 |
| Authorized Official Name | OPAL MULLINGS (MANAGER) |
| Authorized Official Telephone | 2246100434 |
| Is Organization Subpart | Y |
| Parent Organization Name | OPTIMUM FAITH LAB CORP. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245772748 | Optimum Faith Lab Corp | Clinical Medical Laboratory | 1014 Washington St, Waukegan, IL 60085-5429 | 2016-11-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OPTIMUM FAITH LAB CORP. | 1109 Washington St, Waukegan, IL 60085-5301 |
| Street Address |
1109 WASHINGTON ST |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-5301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 332BN1400X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Nursing Facility Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969687 | Alden Estates-courts of Huntley, Inc. | Durable Medical Equipment & Medical Supplies | 12140b Regency Pkwy, Huntley, IL 60142-7554 | 2020-07-13 |
| 1558827535 | Fam Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 1321 W 111th Pl, Chicago, IL 60643-3648 | 2019-02-14 |
| 1518410414 | Morse L Drugs Inc. | Durable Medical Equipment & Medical Supplies | 1407 W Morse Ave, Chicago, IL 60626-3481 | 2016-07-27 |
| 1023426756 | Universe Optimax Inc | Durable Medical Equipment & Medical Supplies | 5632 Dempster St, Morton Grove, IL 60053-3100 | 2014-07-25 |
| 1043577935 | Better Body Boot Camp Inc | Durable Medical Equipment & Medical Supplies | 23280 W Lone Tree Ln, Lake Zurich, IL 60047-9063 | 2012-04-16 |
| 1790011344 | Stat Medical Supply Company | Durable Medical Equipment & Medical Supplies | 1510 Westbury Cir, North Aurora, IL 60542-1755 | 2009-11-02 |
| 1316188493 | Lois B Moore | Durable Medical Equipment & Medical Supplies | 5306 S Hoyne Ave, Chicago, IL 60609-5543 | 2009-03-18 |
| 1538305198 | Kcamlaed Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 16900 Lathrop Ave, Harvey, IL 60426-6033 | 2008-12-31 |
| 1184869240 | Global Medical Products LLC. | Durable Medical Equipment & Medical Supplies | 3209 N Lakewood Ave, Chicago, IL 60657-3215 | 2008-12-03 |
| 1871754705 | All Access Medical Equipment & Supplies Corporation | Durable Medical Equipment & Medical Supplies | 3503 High Ridge Rd, Carpentersville, IL 60110-3221 | 2008-06-23 |
| Find all providers with the same taxonomy | ||||
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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.