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General NPI Number Information
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NPI Number | 1760072292
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Entity Type | Organization
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Legal Business Name | MOBILE HEALTH LABS LLC
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 2644 DEMPSTER ST STE 202
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City | PARK RIDGE
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State | IL
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Zip | 60068-8431
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Country | US
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Telephone | 224-361-3054
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Fax | 224-875-3040
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Provider Business Mailing Address
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Address Line | 2644 DEMPSTER ST STE 202
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City | PARK RIDGE
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State | IL
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Zip | 60068-8431
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Country | US
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Telephone | 224-361-3054
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Fax | 224-875-3040
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | NINEF JOHN ISHOO
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Credential |
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Telephone | 312-804-3794
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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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