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General NPI Number Information
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NPI Number | 1619663226
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Entity Type | Organization
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Legal Business Name | ALC DIAGNOSTICS LLC
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 2434 E DEMPSTER ST STE 110
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City | DES PLAINES
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State | IL
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Zip | 60016-5339
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Country | US
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Telephone | 872-201-8642
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Fax |
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Provider Business Mailing Address
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Address Line | 2434 E DEMPSTER ST STE 110
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City | DES PLAINES
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State | IL
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Zip | 60016-5339
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Country | US
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Telephone | 872-201-8642
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SYED K HAQUE
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Credential | MD
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Telephone | 630-504-8423
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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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