Healthcare Provider Details

I. General information

NPI: 1053085373
Provider Name (Legal Business Name): BEING HUMAN MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6027 N CICERO AVE
CHICAGO IL
60646-4301
US

IV. Provider business mailing address

5252 PRATT AVE
SKOKIE IL
60077-3434
US

V. Phone/Fax

Practice location:
  • Phone: 312-858-1486
  • Fax:
Mailing address:
  • Phone: 312-375-2359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ANOOP MAMTANI
Title or Position: CEO
Credential:
Phone: 312-375-2359