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General NPI Number Information
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NPI Number | 1003569823
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Entity Type | Organization
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Legal Business Name | COVIFREE LAB
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 2706 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60614-1414
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Country | US
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Telephone | 224-730-8465
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Fax |
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Provider Business Mailing Address
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Address Line | 2706 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60614-1414
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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 | PHARMACIST
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Name | DR. ARQAM HAKEEM
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Credential | PHARM.D.
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Telephone | 224-730-8465
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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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