Provider Demographics
NPI:1205839115
Name:CML-CHICAGO MARKET LABS, INC.
Entity Type:Organization
Organization Name:CML-CHICAGO MARKET LABS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-6000
Mailing Address - Street 1:20 BURTON HILLS BLVD
Mailing Address - Street 2:ATTN: CAROL BAILEY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6197
Mailing Address - Country:US
Mailing Address - Phone:615-665-6000
Mailing Address - Fax:615-665-6184
Practice Address - Street 1:3231 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3471
Practice Address - Country:US
Practice Address - Phone:708-783-0737
Practice Address - Fax:708-783-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILD019131291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200194990AMedicaid
IN000000221539OtherANTHEM
IL21623281OtherBLUE CROSS
IL690008950OtherRAILROAD
IL=========001Medicaid
IL=========001Medicaid
IL578770Medicare Oscar/Certification