Healthcare Provider Details

I. General information

NPI: 1285887372
Provider Name (Legal Business Name): TZAM DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 HOLSTE RD
NORTHBROOK IL
60062-7716
US

IV. Provider business mailing address

1880 HOLSTE RD
NORTHBROOK IL
60062-7716
US

V. Phone/Fax

Practice location:
  • Phone: 847-256-3238
  • Fax: 847-256-3239
Mailing address:
  • Phone: 847-256-3238
  • Fax: 847-256-3239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number14D1039167
License Number StateIL

VIII. Authorized Official

Name: HONGJUN ZHANG
Title or Position: VICE PRESIDENT
Credential:
Phone: 847-256-3238