Healthcare Provider Details

I. General information

NPI: 1619663226
Provider Name (Legal Business Name): ALC DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2434 E DEMPSTER ST STE 110
DES PLAINES IL
60016-5339
US

IV. Provider business mailing address

2434 E DEMPSTER ST STE 110
DES PLAINES IL
60016-5339
US

V. Phone/Fax

Practice location:
  • Phone: 872-201-8642
  • Fax:
Mailing address:
  • Phone: 872-201-8642
  • 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: DR. SYED K HAQUE
Title or Position: OWNER
Credential: MD
Phone: 630-504-8423