Healthcare Provider Details

I. General information

NPI: 1891511309
Provider Name (Legal Business Name): UNITED DOCTORS LAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2024
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TRANSAM PLAZA DR STE 16A
OAKBROOK TERRACE IL
60181-4822
US

IV. Provider business mailing address

1 TRANSAM PLAZA DR STE 16A
OAKBROOK TERRACE IL
60181-4822
US

V. Phone/Fax

Practice location:
  • Phone: 630-440-7786
  • Fax:
Mailing address:
  • Phone: 872-226-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL

VIII. Authorized Official

Name: SEYEDEHSOGOL NIKNEZHAD
Title or Position: PRESIDENT
Credential:
Phone: 872-226-0303