Healthcare Provider Details

I. General information

NPI: 1649193418
Provider Name (Legal Business Name): TRUMED CLINICAL LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 W PETERSON AVE STE 102
CHICAGO IL
60659-4030
US

IV. Provider business mailing address

2545 W PETERSON AVE STE 102
CHICAGO IL
60659-4030
US

V. Phone/Fax

Practice location:
  • Phone: 773-943-0322
  • Fax:
Mailing address:
  • Phone: 773-943-0322
  • 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: FNU SAMIULLAH
Title or Position: OWNER
Credential:
Phone: 773-943-0322