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NPI Code Detail

MEDICARE: ACCUSCI LABS INC

MEDICARE: ACCUSCI LABS 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 : 1568753259
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACCUSCI LABS INC
Provider Business Mailing Address
First Line : 3510 W 79TH ST
Second Line : SUITE 3
City : CHICAGO
State : IL
Zip : 60652-1430
Country : US
Telephone Number : 773-863-5164
Fax Number : 773-863-8819
Provider Business Practice Location Address
First Line : 3510 W 79TH ST
Second Line : SUITE 3
City : CHICAGO
State : IL
Zip : 60652-1430
Country : US
Telephone Number : 773-863-5164
Fax Number : 773-863-8819
Authorized Official
Title or Position : PRESIDENT
Name : DR. RUDYARD U SMITH
Credential : M.D.
Telephone Number : 773-459-9661
Provider Enumeration Date : 04/28/2011
Last Update Date : 04/28/2011

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