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General NPI Number Information
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NPI Number | 1952057523
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Entity Type | Organization
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Legal Business Name | ABDUL AND BANDY LLC
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 4437 E STATE ST # 3
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City | ROCKFORD
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State | IL
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Zip | 61108-2114
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Country | US
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Telephone | 815-627-0419
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Fax |
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Provider Business Mailing Address
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Address Line | 816 N COOLIDGE AVE
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City | PALATINE
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State | IL
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Zip | 60067-2224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | TAHA MIRZA
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Credential | DDOS
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Telephone | 847-322-8054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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