Healthcare Provider Details

I. General information

NPI: 1922259753
Provider Name (Legal Business Name): BOSTON HEART DIAGNOSTICS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18000 W 99TH ST STE 200
LENEXA KS
66219-1233
US

IV. Provider business mailing address

PO BOX 1458
CAROL STREAM IL
60132-1458
US

V. Phone/Fax

Practice location:
  • Phone: 508-877-8711
  • Fax: 508-877-1002
Mailing address:
  • Phone: 508-877-8711
  • Fax: 508-877-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW URBANEK
Title or Position: DIRECTOR
Credential:
Phone: 816-799-1610