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MEDLOGIC LLC
NPI 1477900785
Clinic/Center - Primary Care in Libertyville, IL

Active since May 17, 2016CLIA Certified · 2 labs
114 WEST ROCKLAND ROAD, SUITE 201, LIBERTYVILLE, IL 60048(847) 881-6858(847) 906-8597 Get Directions Write a Review

NPPES record last updated: May 17, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Medlogic Llc NPPES

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

MEDLOGIC LLC (NPI 1477900785) is a healthcare organization registered as a primary care in Libertyville, Illinois and active in the NPI registry since May 2016. The organization holds 2 active CLIA laboratory certificates and lists Jill C Tydell, Owner, as its authorized official.

NPPES Registry Identity

NPI1477900785
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMEDLOGIC LLC
Location Address114 WEST ROCKLAND ROAD, SUITE 201Libertyville, IL 60048
Mailing Address5 Timberline LaneRiverwoods, IL 60015 · (847) 946-8871 · Fax (847) 906-8597
Phone(847) 881-6858
Fax(847) 906-8597
Organization SubpartNo
Authorized OfficialJill C TydellOwner · (847) 946-8871
Enumeration DateMay 17, 2016
✔ NPI 1477900785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in IL · 036139402
114 WEST ROCKLAND ROAD, Libertyville, IL 60048
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CLIA Laboratory Certificates CMS CLIA 2

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 14D2113757

Medlogic LLC · Bannockburn, IL
Active · expires May 30, 2028
CLIA Number14D2113757
Laboratory TypePhysician Office
Certificate Effective DateMay 31, 2026
Certificate Expiration DateMay 30, 2028
Laboratory DirectorJill Green MD
Laboratory Phone(847) 881-6858
Laboratory LocationMedlogic LLC2101 Waukegan Rd, Ste 303, Bannockburn, IL 60015
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 52D2129830

Medlogic, LLC · Kenosha, WI
Active · expires Apr 25, 2027
CLIA Number52D2129830
Laboratory TypePhysician Office
Certificate Effective DateApril 26, 2025
Certificate Expiration DateApril 25, 2027
Laboratory DirectorJill Green
Laboratory Phone(847) 881-6858
Laboratory LocationMedlogic, LLC1452 Sheridan Rd, Kenosha, WI 53140
CLIA data matches this NPI record on: Name Phone
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 Medlogic LLC's NPI number?

The NPI number for Medlogic LLC is 1477900785. It was assigned to this organization in the NPPES registry on May 17, 2016.

Where is Medlogic LLC located?

Medlogic LLC is located at 114 West Rockland Road Suite 201, Libertyville, IL 60048. The listed phone number is (847) 881-6858.

What is Medlogic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Medlogic LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Medlogic LLC was last updated on May 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.