| NPI | 1174636658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL PARK President 815-489-4267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: IL 36063669) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2012-10-09 |