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NPI Code Detail

MEDICARE: NRI LABORATORIES INC

MEDICARE: NRI LABORATORIES 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 Laboratory14D0646644IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001633071OTHERILBCBS - IL
2244163OTHERILHARMONY HEALTH PLAN

General Provider Information

NPI Number : 1598763914
Entity Type Code : Organization
Provider Name (Legal Business Name) : NRI LABORATORIES INC
Provider Business Mailing Address
First Line : 5960 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-5424
Country : US
Telephone Number : 773-775-6743
Fax Number : 773-775-6673
Provider Business Practice Location Address
First Line : 5960 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-5424
Country : US
Telephone Number : 773-775-6743
Fax Number : 773-775-6673
Authorized Official
Title or Position : PRESIDENT
Name : MR. REYNALDO ILAGAN
Credential : PRESIDENT
Telephone Number : 773-773-6743
Provider Enumeration Date : 07/09/2005
Last Update Date : 04/02/2010

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Practice Location Address:
5946 N MILWAUKEE AVE
CHICAGO, IL
60646-5424
Practice Phone: 773-775-6637
Practice Fax: 773-775-6638
1477507325 — INTEGRATED THERAPY SPECIALISTS, L.L.C.
Practice Location Address:
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1770520611 — CARY JOSE M ACOPIADO DPT
Practice Location Address:
5946 N MILWAUKEE AVE
CHICAGO, IL
60646-5424
Practice Phone: 773-775-6637
Practice Fax: 773-775-6638
1578500419 — DON JORGE U PAGUNTALAN P.T.
Practice Location Address:
5946 N MILWAUKEE AVE
CHICAGO, IL
60646-5424
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Practice Fax: 773-775-6638
1891733697 — INTEGRATED THERAPY SPECIALISTS, L.L.C.
Practice Location Address:
5946 N MILWAUKEE AVE
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60646-5424
Practice Phone: 773-775-6637
Practice Fax: 773-775-6638
1013958784 — MR. MICHAEL L EDQUIBAN PT
Practice Location Address:
5946 N MILWAUKEE AVENUE , 1ST FLOOR
CHICAGO, IL
60646-5424
Practice Phone: 773-775-6637
Practice Fax: 773-775-6638

Directions to “NRI LABORATORIES INC ” Practice Location

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