| NPI | 1659370047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAL ALWATTAR President 847-480-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: IL 14D0950557) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: FL 10D1044289) |
| 291U00000X Clinical Medical Laboratory (Licence: IL 14D1106803) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2011-12-21 |