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General NPI Number Information
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NPI Number | 1992299119
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Entity Type | Organization
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Legal Business Name | LUMI DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 2222 W DIVISION ST STE 220
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City | CHICAGO
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State | IL
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Zip | 60622-3094
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Country | US
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Telephone | 773-486-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 10 YORK LAKE CT
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City | OAK BROOK
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State | IL
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Zip | 60523-2721
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Country | US
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Telephone | 773-486-7800
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Fax | 773-384-6176
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SAFDAR ALI
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Credential | MD
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Telephone | 773-486-7800
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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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