| |
2207 W Lake St Melrose Park IL 60160-3620 | |
(630) 463-8185 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinical Medical Laboratory |
Location | 2207 W Lake St, Melrose Park, Illinois |
Authorized Official Name and Position | Mohammad Arif Hockla (PRESIDENT) |
Authorized Official Contact | 6309653716 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
2207 W Lake St Melrose Park IL 60160-3620 Ph: (630) 463-8185 | 2207 W Lake St Melrose Park IL 60160-3620 Ph: (630) 463-8185 |
NPI Number | 1902559537 |
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Provider Enumeration Date | 02/02/2022 |
Last Update Date | 02/17/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902559537 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
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