MEDICARE: RAPID HEALTHCARE LABORATORY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1003560624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPID HEALTHCARE LABORATORY LLC

Provider Business Mailing Address
First Line	:	881 E CHICAGO ST FL 2
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-6818
Country	:	US
Telephone Number	:	708-699-9237
Fax Number	:

Provider Business Practice Location Address
First Line	:	881 E CHICAGO ST FL 2
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-6818
Country	:	US
Telephone Number	:	815-362-4439
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FNU MOHAMMED BASHEER ALI
Credential	:
Telephone Number	:	773-200-9827

Provider Enumeration Date	:	02/11/2022
Last Update Date	:	09/25/2024

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