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General NPI Number Information
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NPI Number | 1912650342
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Entity Type | Organization
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Legal Business Name | DUPAGE LABS LLC
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Dates
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Enumeration Date | 01/26/2022
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 1800 W HAWTHORNE LN STE 205
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City | WEST CHICAGO
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State | IL
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Zip | 60185-1863
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Country | US
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Telephone | 630-869-0835
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 W HAWTHORNE LN STE 205
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City | WEST CHICAGO
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State | IL
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Zip | 60185-1863
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Country | US
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Telephone | 630-869-0835
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SHOAIB SIDDIQUI
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Credential |
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Telephone | 630-400-5152
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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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