| Premier Vascular Laboratory | |
|
3736 W 26th St Chicago IL 60623-3826 | |
| (773) 277-1100 | |
| Not Available |
| Full Name | Premier Vascular Laboratory |
|---|---|
| Speciality | Clinic/center |
| Location | 3736 W 26th St, Chicago, Illinois |
| Authorized Official Name and Position | Eugene M Tanquilut (MEMBER) |
| Authorized Official Contact | 7083050248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Vascular Laboratory 16406 Pepperwood Trl Orland Hills IL 60487-5644 Ph: (708) 305-2620 | Premier Vascular Laboratory 3736 W 26th St Chicago IL 60623-3826 Ph: (773) 277-1100 |
| NPI Number | 1285812529 |
|---|---|
| Provider Enumeration Date | 02/08/2008 |
| Last Update Date | 02/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285812529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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