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General NPI Number Information
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NPI Number | 1790465367
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Entity Type | Organization
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Legal Business Name | ADVANCED DIAGNOSTIC SOLUTIONS INC
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 17W703 BUTTERFIELD RD STE A
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4280
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Country | US
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Telephone | 224-341-5653
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Fax | 224-998-0851
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Provider Business Mailing Address
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Address Line | 6134 N CAMPBELL AVE APT 3
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City | CHICAGO
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State | IL
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Zip | 60659-4161
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Country | US
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Telephone | 224-341-5653
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Fax | 224-998-0851
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | FASIUR SYED
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Credential |
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Telephone | 224-341-5653
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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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