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General NPI Number Information
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NPI Number | 1780344911
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Entity Type | Organization
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Legal Business Name | UNITED DL II
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 2521 GROSS POINT RD STE 5
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City | EVANSTON
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State | IL
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Zip | 60201-4993
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Country | US
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Telephone | 312-890-4340
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Fax |
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Provider Business Mailing Address
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Address Line | 2521 GROSS POINT RD STE 1B
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City | EVANSTON
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State | IL
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Zip | 60201-4993
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Country | US
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Telephone | 312-890-4340
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHAN M ERDELYI
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Credential |
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Telephone | 847-346-5070
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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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