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General NPI Number Information
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NPI Number | 1558440768
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Entity Type | Organization
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Legal Business Name | SNAP LABORATORIES INTERNATIONAL, LLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5210 CAPITOL DR
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City | WHEELING
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State | IL
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Zip | 60090-7901
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Country | US
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Telephone | 847-777-0000
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Fax | 847-465-3404
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Provider Business Mailing Address
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Address Line | 5210 CAPITOL DR
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City | WHEELING
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State | IL
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Zip | 60090-7901
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Country | US
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Telephone | 847-777-0000
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Fax | 847-465-3404
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GIL RAVIV
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Credential | PH.D.
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Telephone | 847-777-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | WR000335
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License Number State | IL
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