Healthcare Provider Details
I. General information
NPI: 1619834587
Provider Name (Legal Business Name): ORISDX INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 N ABERDEEN ST STE 900
CHICAGO IL
60642-6549
US
IV. Provider business mailing address
400 N ABERDEEN ST STE 900
CHICAGO IL
60642-6549
US
V. Phone/Fax
- Phone: 630-800-7379
- Fax:
- Phone: 630-800-7379
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
PATRICK
CONNIFF
Title or Position: COO/CFO
Credential: MBA
Phone: 630-800-7379