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General NPI Number Information
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NPI Number | 1659370047
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Entity Type | Organization
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Legal Business Name | CMS LABS INC
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 1818 SKOKIE BLVD
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City | NORTHBROOK
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State | IL
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Zip | 60062-4106
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Country | US
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Telephone | 847-656-0194
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Fax | 847-714-1615
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Provider Business Mailing Address
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Address Line | 1818 SKOKIE BLVD
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City | NORTHBROOK
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State | IL
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Zip | 60062-4106
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Country | US
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Telephone | 847-656-0194
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Fax | 847-714-1615
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMAL ALWATTAR
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Credential | M.S.
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Telephone | 847-480-4680
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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 | 10D1044289
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 14D1106803
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 14D0950557
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License Number State | IL
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