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General NPI Number Information
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NPI Number | 1003569658
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Entity Type | Organization
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Legal Business Name | SUN MEDICAL LABORATORIES INC
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 2 E 22ND ST STE 306
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City | LOMBARD
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State | IL
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Zip | 60148-6106
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Country | US
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Telephone | 773-387-4296
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Fax |
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Provider Business Mailing Address
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Address Line | 532 CARLISLE CT
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City | GLEN ELLYN
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State | IL
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Zip | 60137-6702
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SAUD SIDDIQUI
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Credential |
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Telephone | 773-387-4296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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