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General NPI Number Information
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NPI Number | 1598538175
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Entity Type | Organization
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Legal Business Name | SIMPLIPATH, PLLC
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 960 OLD GREEN BAY RD
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City | WINNETKA
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State | IL
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Zip | 60093-1710
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Country | US
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Telephone | 312-725-8628
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Fax |
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Provider Business Mailing Address
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Address Line | 250 PARKWAY DR STE 150
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-4340
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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 | COO
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Name | CRAIG LAN
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Credential |
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Telephone | 224-409-3428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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