ELMHURST CLINIC (ELMHURST MEMORIAL HEALTHCARE) NPI 1003046103

Durable Medical Equipment & Medical Supplies in Addison, IL

NPI 1003046103 Organization Durable Medical Equipment & Medical Supp... CLIA Number 14D2121078 CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP)

About ELMHURST CLINIC (ELMHURST MEMORIAL HEALTHCARE)

Elmhurst Clinic (elmhurst Memorial Healthcare) is a provider established in Addison, Illinois specializing in durable medical equipment & medical supplies. The NPI number of Elmhurst Clinic (elmhurst Memorial Healthcare) is 1003046103 and was assigned on July 2009. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Elmhurst Clinic. The authorized official of this NPI record is Donald Lurye Md (Ceo)

The CLIA number of Elmhurst Clinic is 14D2121078 registered as a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Elmhurst Clinic in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI

1003046103

Provider NameELMHURST CLINIC (ELMHURST MEMORIAL HEALTHCARE)
Provider Location Address303 W LAKE ST SUITE 202 ADDISON, IL 60101
Provider Mailing Address172 SCHILLER ST ELMHURST, IL 60126
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameELMHURST CLINIC
Other Name TypeDoing Business As (3)
Enumeration Date07-23-2009
Last Update Date11-08-2018


Primary Taxonomy

Taxonomy Code332B00000X
ClassificationDurable Medical Equipment & Medical Supplies
TypeSuppliers
Taxonomy DescriptionA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Business Address

ELMHURST CLINIC
303 W LAKE ST
SUITE 202
ADDISON, IL
ZIP 60101
Phone: (630) 953-3301
Fax: (630) 953-3302

Get Directions


Mailing Address

ELMHURST CLINIC
172 SCHILLER ST
ELMHURST, IL
ZIP 60126
Phone: (331) 221-6377
Fax: (331) 221-2706



Authorized Official

Authorized Official Name DONALD LURYE MD
Authorized Official TitleCEO
Authorized Official Phone(331) 221-9055

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003046103 is:

CLIA Number14D2121078
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate for Provider-Performed Microscopy Procedures (PPMP)

Other Providers at the same location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1912968785DUPAGE MEDICAL ASSOCIATES, SC
Organization
Internal Medicine303 W LAKE ST SUITE 206
ADDISON, IL 60101
(630) 543-4200
1659481778DR. MERRICK JAY BROMBERG D.O.
Individual
Pediatrics303 W LAKE ST SUITE 102
ADDISON, IL 60101
(630) 543-3020
1578691846FMGC, S.C.
Organization
Internal Medicine (Gastroenterology)303 W LAKE ST STE. 205
ADDISON, IL 60101
(630) 458-8855
1518178987DR. MARYANN ELIZABETH MICHAEL D.D.S.
Individual
Dentist (General Practice)303 W LAKE ST SUITE203
ADDISON, IL 60101
(630) 458-9845
1033368352DALE LIAUGMINAS, M.D. S.C.
Organization
Specialist303 W LAKE ST #201
ADDISON, IL 60101
(630) 628-8450
1225274467ELMHURST MEMORIAL AFFILIATED PRIMARY CARE PHYSICIANS, LLC
Organization
Clinic/Center303 W LAKE ST SUITE 206
ADDISON, IL 60101
(630) 543-4200
1336770239 MARY JO MCDONNELL LCPC
Individual
Counselor (Professional)303 W LAKE ST
ADDISON, IL 60101
(630) 305-5164
1679836647 ANDREW W FRANCIS M.D.
Individual
Ophthalmology (Retina Specialist)303 W LAKE ST STE 303
ADDISON, IL 60101
(630) 225-7247
1700908498AD-PARK PEDIATRIC ASSOCIATES, S.C.
Organization
Pediatrics303 W LAKE ST SUITE 102
ADDISON, IL 60101
(630) 543-3020
1669061545MRS. AARIKA MILLER LCSW, CDVP
Individual
Social Worker (Clinical)303 W LAKE ST
ADDISON, IL 60101
(331) 221-9000
1396127239DR. KRUNAL PATEL MD
Individual
Internal Medicine303 W LAKE ST SUITE 200
ADDISON, IL 60101
(331) 221-9001
1851787154MR. ROBERT BERNARD ALLANSON M.S., LCPC, CADC
Individual
Counselor (Professional)303 W LAKE ST
ADDISON, IL 60101
(331) 221-1652

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.