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General NPI Number Information
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NPI Number | 1881630614
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Entity Type | Organization
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Legal Business Name | QUEST DIAGNOSTICS LLC IL
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1355 MITTEL BLVD
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City | WOOD DALE
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State | IL
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Zip | 60191-1024
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Country | US
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Telephone | 800-323-5917
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Fax |
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Provider Business Mailing Address
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Address Line | 14275 MIDWAY RD STE 400
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City | ADDISON
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State | TX
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Zip | 75001-3661
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Country | US
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Telephone |
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Fax | 610-271-4245
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LEAH D TIMMERMAN
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Credential |
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Telephone | 973-520-2700
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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 | 14D0417052
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License Number State | IL
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