Healthcare Provider Details

I. General information

NPI: 1144824483
Provider Name (Legal Business Name): TBX GROUP OF INDUSTRIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2020
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 W ALGONQUIN RD
LAKE IN THE HILLS IL
60156-3575
US

IV. Provider business mailing address

1303 W ALGONQUIN RD
LAKE IN THE HILLS IL
60156-3575
US

V. Phone/Fax

Practice location:
  • Phone: 312-722-6940
  • Fax: 888-502-0521
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ABHISHEK GULATI
Title or Position: OWNER
Credential:
Phone: 312-752-7226