| NPI | 1720378524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FELICELDA Administrator 847-802-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 246QM0706X Spec/Tech, Pathology, Medical Technologist |
| 246RM2200X Technician, Pathology, Medical Laboratory | |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2016-04-22 |