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PARK AVENUE PRIVATE PRACTICE LLC
NPI 1851763213
Clinic/Center - Health Service in Highland Park, IL

Active since October 26, 2015CLIA 14D1047511 · Waiver
767 PARK AVE W STE 350, HIGHLAND PARK, IL 60035(847) 433-5505(847) 433-5510 Get Directions Write a Review

NPPES record last updated: February 2, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Park Avenue Private Practice Llc NPPES

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

PARK AVENUE PRIVATE PRACTICE LLC (NPI 1851763213) is a healthcare organization registered as a health service in Highland Park, Illinois and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through November 6, 2027 and lists Jeffrey S Garland, President, Medical Doctor, as its authorized official.

NPPES Registry Identity

NPI1851763213
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NamePARK AVENUE PRIVATE PRACTICE LLC
Location Address767 PARK AVE W STE 350Highland Park, IL 60035-2472
Mailing Address767 Park Ave W Ste 350Highland Park, IL 60035-2472 · (847) 433-5505
Phone(847) 433-5505
Fax(847) 433-5510
Organization SubpartNo
Authorized OfficialJeffrey S GarlandPresident, Medical Doctor · (847) 433-5505
Enumeration DateOctober 26, 2015
Last NPPES UpdateFebruary 2, 2016
✔ NPI 1851763213 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
License✔ Licensed in IL · 248.001237
767 PARK AVE W STE 350, Highland Park, IL 60035
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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 14D1047511

Park Avenue Private Practice LLC · Highland Park, IL
Active · expires Nov 6, 2027
CLIA Number14D1047511
Laboratory TypePhysician Office
Certificate Effective DateNovember 7, 2025
Certificate Expiration DateNovember 6, 2027
Laboratory DirectorJeffrey S. Garland, MD
Laboratory Phone(847) 433-5505
Laboratory LocationPark Avenue Private Practice LLC767 Park Avenue W, Suite 320, Highland Park, IL 60035
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 Park Avenue Private Practice LLC's NPI number?

The NPI number for Park Avenue Private Practice LLC is 1851763213. It was assigned to this organization in the NPPES registry on October 26, 2015.

Where is Park Avenue Private Practice LLC located?

Park Avenue Private Practice LLC is located at 767 Park Ave W Ste 350, Highland Park, IL 60035. The listed phone number is (847) 433-5505.

What is Park Avenue Private Practice LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Does Park Avenue Private Practice LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1047511) is associated with this NPI, valid through November 6, 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 Park Avenue Private Practice LLC was last updated on February 2, 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.