Healthcare Provider Details

I. General information

NPI: 1801667530
Provider Name (Legal Business Name): BJA CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 SAUK TRL STE D
RICHTON PARK IL
60471-1058
US

IV. Provider business mailing address

5111 SAUK TRL STE D
RICHTON PARK IL
60471-1058
US

V. Phone/Fax

Practice location:
  • Phone: 833-955-4277
  • Fax:
Mailing address:
  • Phone: 833-955-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QG0250X
TaxonomyGenetics Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAKEYA ALLEN
Title or Position: OWNER
Credential:
Phone: 708-735-1772