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General NPI Number Information
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NPI Number | 1801541586
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Entity Type | Organization
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Legal Business Name | PSK SERVICES LLC
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 17499 DIXIE HWY
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City | EAST HAZEL CREST
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State | IL
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Zip | 60429-1826
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Country | US
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Telephone | 630-788-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 E GOLF RD STE 950
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City | SCHAUMBURG
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State | IL
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Zip | 60173-5034
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Country | US
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Telephone | 630-788-0111
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ALI KHAN
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Credential |
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Telephone | 630-788-0111
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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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