Healthcare Provider Details

I. General information

NPI: 1861655961
Provider Name (Legal Business Name): SNAP DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 ATRIUM DR STE 100
VERNON HILLS IL
60061-1713
US

IV. Provider business mailing address

616 ATRIUM DR STE 100
VERNON HILLS IL
60061-1713
US

V. Phone/Fax

Practice location:
  • Phone: 847-777-0000
  • Fax: 847-465-3401
Mailing address:
  • Phone: 847-777-0000
  • Fax: 847-465-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. GIL RAVIV
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 847-777-0000