| NPI | 1134811433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IHTESHAM ALI SHAH MO ALI SHAH MOHAMMED President 847-589-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2024-11-09 |