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NPI Code Detail

MEDICARE: MAPLE DIAGNOSTICS INC.

MEDICARE: MAPLE DIAGNOSTICS INC.
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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1043166564
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAPLE DIAGNOSTICS INC.
Provider Business Mailing Address
First Line : 259 E RAND RD
Second Line :
City : MOUNT PROSPECT
State : IL
Zip : 60056-2184
Country : US
Telephone Number : 224-615-5447
Fax Number :
Provider Business Practice Location Address
First Line : 259 E RAND RD
Second Line :
City : MOUNT PROSPECT
State : IL
Zip : 60056-2184
Country : US
Telephone Number : 224-615-5447
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : HARSHITH VASIREDDY
Credential :
Telephone Number : 224-615-5447
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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Directions to “MAPLE DIAGNOSTICS INC. ” Practice Location

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