MEDICARE: HANNAN LAB INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1578223632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANNAN LAB INC

Provider Business Mailing Address
First Line	:	2725 W BALMORAL AVE APT 2E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3232
Country	:	US
Telephone Number	:	872-235-7398
Fax Number	:

Provider Business Practice Location Address
First Line	:	6954 W TOUHY AVE STE 201
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-4535
Country	:	US
Telephone Number	:	872-235-7398
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMMED HYDER ZAMA KHAN
Credential	:
Telephone Number	:	872-235-7398

Provider Enumeration Date	:	12/29/2021
Last Update Date	:	05/01/2024

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Directions to “HANNAN LAB INC ” Practice Location

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