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LONGEVITY CENTERS OF ILLINOIS LLC
NPI 1093427593
Radiology - Diagnostic Radiology in Mundelein, IL

Active since December 16, 2022CLIA 14D2278534 · Waiver
550 N LAKE ST STE 1, MUNDELEIN, IL 60060(847) 593-8460 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 16, 2024, Dec 16, 2022 (2 updates tracked since 2022).

About Longevity Centers Of Illinois Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LONGEVITY CENTERS OF ILLINOIS LLC (NPI 1093427593) is a healthcare organization registered as a diagnostic radiology in Mundelein, Illinois and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through March 19, 2027 and lists Yan Katsnelson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1093427593
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameLONGEVITY CENTERS OF ILLINOIS LLC
Location Address550 N LAKE ST STE 1Mundelein, IL 60060-1827
Mailing AddressPo Box 451Northbrook, IL 60065-0451
Phone(847) 593-8460
Organization SubpartNo
Authorized OfficialYan KatsnelsonCeo · (847) 774-5300
Enumeration DateDecember 16, 2022
Last NPPES UpdateApril 16, 20242 updates tracked since enumeration
NPPES CertifiedApril 16, 2024
✔ NPI 1093427593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
550 N LAKE ST STE 1, Mundelein, IL 60060
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2278534

Longevity Centers Of Illinois, LLC · Mundelein, IL
Active · expires Mar 19, 2027
CLIA Number14D2278534
Laboratory TypePhysician Office
Certificate Effective DateMarch 20, 2025
Certificate Expiration DateMarch 19, 2027
Laboratory DirectorSergei Shevlyagin
Laboratory Phone(847) 257-1237
Laboratory LocationLongevity Centers Of Illinois, LLC550 N Lake St, Mundelein, IL 60060
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Longevity Centers Of Illinois LLC's NPI number?

The NPI number for Longevity Centers Of Illinois LLC is 1093427593. It was assigned to this organization in the NPPES registry on December 16, 2022.

Where is Longevity Centers Of Illinois LLC located?

Longevity Centers Of Illinois LLC is located at 550 N Lake St Ste 1, Mundelein, IL 60060. The listed phone number is (847) 593-8460.

What is Longevity Centers Of Illinois LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Does Longevity Centers Of Illinois LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2278534) is associated with this NPI, valid through March 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Longevity Centers Of Illinois LLC was last updated on April 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.