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14D2019155 CLIA NUMBER - STREETERVILLE INTERNAL MEDICINE LLC

Laboratory Demographics

CLIA Number: 14D2019155

Facility Name: STREETERVILLE INTERNAL MEDICINE LLC

Facility Address:
676 N SAINT CLAIR ST, STE 1740
CHICAGO, IL
ZIP 60611
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Facility Phone Number: 312 926-0444

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1053684852

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 14D2019155
LAB Type Physician Office
Facility Name STREETERVILLE INTERNAL MEDICINE LLC
Street 676 N SAINT CLAIR ST, STE 1740
City CHICAGO
State IL
ZIP 60611
Phone 312 926-0444
CertificateType 3
CertificateEffectiveDate 1/24/2023
CertificateExpirationDate 1/23/2025
FacilityType PPMP

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This page was last updated on: 4/23/2024