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General NPI Number Information
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NPI Number | 1760145387
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Entity Type | Organization
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Legal Business Name | LOTION PRO INC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 6209 N FAIRFIELD AVE APT 3
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City | CHICAGO
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State | IL
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Zip | 60659-3558
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Country | US
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Telephone | 312-684-4726
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Fax |
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Provider Business Mailing Address
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Address Line | 6209 N FAIRFIELD AVE APT 3
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City | CHICAGO
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State | IL
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Zip | 60659-3558
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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 | PRESIDENT
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Name | MAHMOOD KHAJA SYED
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Credential |
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Telephone | 312-998-7123
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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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