Healthcare Provider Details

I. General information

NPI: 1861145799
Provider Name (Legal Business Name): ARAM KENNETH HONORE PHLEBOTOMIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2022
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE STE 1116-LM
CHICAGO IL
60602-1903
US

IV. Provider business mailing address

7516 KEDVALE AVE
SKOKIE IL
60076-3804
US

V. Phone/Fax

Practice location:
  • Phone: 312-800-3395
  • Fax:
Mailing address:
  • Phone: 312-800-3395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberNAPTP32963677098
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: