MEDICARE: NEO PATH SC

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number	:	1235138694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEO PATH SC

Provider Business Mailing Address
First Line	:	520 E 22ND ST
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-6110
Country	:	US
Telephone Number	:	630-874-2542
Fax Number	:

Provider Business Practice Location Address
First Line	:	ST. ALEXIUS MEDICAL CENTER/PATHOLOGY DEPT
Second Line	:	1555 N. BARRINGTON RD.
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60194
Country	:	US
Telephone Number	:	847-843-2000
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	VEN A. ADUANA
Credential	:	M.D.
Telephone Number	:	847-843-2000

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	05/16/2023

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