MEDICARE: QUALITY PHLEBOTOMY L.L.C

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	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1205432457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY PHLEBOTOMY L.L.C

Provider Business Mailing Address
First Line	:	2051 217TH ST
Second Line	:
City	:	SAUK VILLAGE
State	:	IL
Zip	:	60411-4520
Country	:	US
Telephone Number	:	708-631-8931
Fax Number	:

Provider Business Practice Location Address
First Line	:	2051 217TH ST
Second Line	:
City	:	SAUK VILLAGE
State	:	IL
Zip	:	60411-4520
Country	:	US
Telephone Number	:	708-631-8931
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMARIA SING
Credential	:	PHLEBOTOMIST
Telephone Number	:	708-631-8931

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	02/10/2022

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