Provider Demographics
NPI:1407561723
Name:VISTALINK HEALTH LABS-CHICAGO LLC
Entity Type:Organization
Organization Name:VISTALINK HEALTH LABS-CHICAGO LLC
Other - Org Name:CLINICCARE LABORATORIES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-951-1277
Mailing Address - Street 1:100 TRISTATE INTERNATIONAL STE 240
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-4418
Mailing Address - Country:US
Mailing Address - Phone:833-831-8163
Mailing Address - Fax:
Practice Address - Street 1:100 TRISTATE INTERNATIONAL STE 240
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-4418
Practice Address - Country:US
Practice Address - Phone:276-469-8925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D2263706OtherCLIA