EVERGREEN SHERIDAN LABORATORIES LTD (NPI# 1972513661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972513661 |
| Entity Type | Organization |
| Organization Name | EVERGREEN SHERIDAN LABORATORIES LTD |
| Practice Address |
9760 S Kedzie Ave Evergreen Park IL 60805 |
| Practice Telephone | 7084232660 |
| Practice Fax Number | 7084231960 |
| Mailing Telephone | 7084232660 |
| Mailing Fax Number | 7084231960 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2008-06-12 |
| Authorized Official Name | MS. KAREN A JUTZI (OWNER) |
| Authorized Official Telephone | 7084232660 |
| Authorized Official Credential | LAB TECHNOLOGIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 50000044 | 01 |
| Street Address |
9760 S KEDZIE AVE |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306836663 | Thomas Joseph | Internal Medicine | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2005-10-26 |
| 1518445543 | Christine Najarian | Physician Assistant | 9760 S Kedzie Ave, Evergreen Park, IL 60805-3109 | 2018-08-01 |
| 1760927057 | Wellcare Pharmacy LLC | Pharmacy | 9760 S Kedzie Ave, Evergreen Park, IL 60805-3109 | 2016-12-22 |
| 1457894768 | Rachel Brucas | Physician Assistant | 9760 S Kedzie Ave, Evergreen Park, IL 60805-3109 | 2016-11-18 |
| 1841587334 | Kristina Ann Johnson | Family Medicine | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2011-07-05 |
| 1033438460 | Health Solutions At Home Inc | Home Health | 9760 S Kedzie Ave, Suite 10b, Evergreen Park, IL 60805-3109 | 2010-05-25 |
| 1487987707 | Alicia Lopez | Pediatrics | 9760 S Kedzie Ave, Suite 11, Evergreen Park, IL 60805-3109 | 2009-09-18 |
| 1073746046 | George Thomas | Family Medicine | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2009-08-25 |
| 1447449616 | Evergreen Care Center Ltd | General Practice | 9760 S Kedzie Ave, Suite 3, Evergreen Park, IL 60805-3109 | 2007-10-23 |
| 1891984068 | Park Primary Care Ltd | General Practice | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2007-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| 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 |
|---|---|---|---|---|
| 1700266566 | Central Regional Laboratories, LLC | Clinical Medical Laboratory | 9730 S Western Ave, Suite 706, Evergreen Park, IL 60805-2814 | 2015-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745670 | Rivercross Diagnostics Inc. | Clinical Medical Laboratory | 910 Broadway St Ste Ab, Quincy, IL 62301-2729 | 2020-09-21 |
| 1952915506 | Vip Labs LLC. | Clinical Medical Laboratory | 2555 Lincoln Hwy Ste 104, Olympia Fields, IL 60461-1938 | 2020-09-01 |
| 1538770276 | Precision Phlebotomy Inc | Clinical Medical Laboratory | 9241 S Roberts Rd, Hickory Hills, IL 60457-3809 | 2020-08-15 |
| 1316558182 | Southwest Medical Solutions Inc | Clinical Medical Laboratory | 5533 W 109th St Ste 101, Oak Lawn, IL 60453-5058 | 2020-08-13 |
| 1083232946 | Sjs Medical Labs, LLC D/b/a Arcpoint Labs of Libertyville | Clinical Medical Laboratory | 1659 Northwind Blvd, Libertyville, IL 60048-9613 | 2020-07-08 |
| 1922625961 | Abil Corporation | Clinical Medical Laboratory | 1375 Remington Rd Ste A, Schaumburg, IL 60173-4844 | 2020-06-25 |
| 1588280622 | Radiance Biosciences and Consultancy, LLC | Clinical Medical Laboratory | 1260 Iroquois Ave Ste 302, Naperville, IL 60563-8549 | 2020-06-24 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
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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.