KEN GRAY COMPANY INC. (NPI# 1184081374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184081374 |
| Entity Type | Organization |
| Organization Name | KEN GRAY COMPANY INC. |
| Other Organization Name | GRAY FORENSIC TOXICOLOGY TESTING LABS |
| Practice Address |
451 Mallview Ln Bolingbrook IL 60440-2974 |
| Practice Telephone | 6309145065 |
| Mailing Telephone | 6309145065 |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2016-01-20 |
| Authorized Official Name | DR. KENNETH GRAY SR. (PRESIDENT/ CLINICAL DIRECTOR) |
| Authorized Official Telephone | 6309145065 |
| Is Organization Subpart | Y |
| Parent Organization Name | KEN GRAY COMPANY INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246RM2200X |
Technician, Pathology Specialization: Medical Laboratory |
IL | Technologists, Technicians & Other Technical Service Providers | |
| N | 246RP1900X |
Technician, Pathology Specialization: Phlebotomy |
IL | Technologists, Technicians & Other Technical Service Providers | |
| N | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
IL | Technologists, Technicians & Other Technical Service Providers | |
| Y | 367H00000X | Anesthesiologist Assistant | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| GRAY FORENSIC TOXICOLOGY TESTING LABS | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700241551 | Ken Gray Company Inc. | Naturopath | 451 Mallview Ln, Bolingbrook, IL 60440-2974 | 2015-12-21 |
| Street Address |
451 MALLVIEW LN |
| City | BOLINGBROOK |
| State | IL |
| Zip Code | 60440-2974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427486778 | Kenneth C Gray Sr. | Driver | 451 Mallview Ln, Bolingbrook, IL 60440-2974 | 2013-10-24 |
| 1700241551 | Ken Gray Company Inc. | Naturopath | 451 Mallview Ln, Bolingbrook, IL 60440-2974 | 2015-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1851949150 | Rachel Nicole Weis | Student in an Organized Health Care Education/Training Program | 777 Falconridge Way, Bolingbrook, IL 60440 | 2019-08-29 |
| 1578072815 | Onna Ford-kendrick | Nurse Practitioner | 151 E. Briarcliff Rd, -, Bolingbrook, IL 60440 | 2017-09-28 |
| 1891245213 | Megan Lotarski | Specialist/Technologist | 6 Copper Ct, Bolingbrook, IL 60440 | 2016-10-10 |
| 1144775800 | Mitchell Quill | Chiropractor | 550 E Boughton Rd Ste 150, Bolingbrook, IL 60440 | 2016-08-23 |
| 1477914125 | Alessia L. Elerby | Specialist | 128 S Cass Ave, Westmont, IL 60440 | 2016-03-09 |
| 1982073821 | Melissa Perkins | Counselor | 511 Preston Drive, Bolingbrook, IL 60440 | 2015-09-22 |
| 1821467754 | Advanced Patient Care, LLC. | Pharmacy | 335-337 Remington Blvd., Bolingbrook, IL 60440 | 2015-09-22 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| 1467864512 | Alice II Salons | Specialist | 311 Quadr,., Bolingbrook, IL 60440 | 2014-05-23 |
| Find all providers in zip 60440 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396286399 | Andreja Lakic | Anesthesiologist Assistant | 653 Mulberry Dr, Prospect Heights, IL 60070-3427 | 2017-03-10 |
| 1144722802 | Midwest Anesthesia and Pain Services LLC | Anesthesiologist Assistant | 10181 W Lincoln Hwy, Frankfort, IL 60423-1274 | 2018-03-08 |
| 1205149010 | Anna M Varvel | Anesthesiologist Assistant | 800 E Carpenter St, Springfield, IL 62769-9999 | 2010-07-21 |
| 1164463782 | Brenda R Greene | Anesthesiologist Assistant | 1800 Hollister Dr, Suite 202, Libertyville, IL 60048-5263 | 2006-06-08 |
| City | BOLINGBROOK |
| Zip Code | 60440 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.