# PARK RIDGE LAB INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558635516
- **Authorized official:** DR. SAM SPERON MD (PRESIDENT)
- **Authorized official phone:** (847) 696-9900

## Contact information

- **Practice address:** 950 N NORTHWEST HWY STE 102, PARK RIDGE, IL 60068-2349
- **Practice address phone:** (847) 696-9900
- **Practice address fax:** (630) 952-1447
- **Mailing address:** 950 N NORTHWEST HWY STE 102, PARK RIDGE, IL 60068-2349
- **Mailing address phone:** (847) 696-9900
- **Mailing address fax:** (630) 952-1447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZH0000X | Hematology (Pathology) Physician | — | NULL | Yes |
| 207ZH0000X | Hematology (Pathology) Physician | — | — | Yes |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 03/07/2012
- **Last updated:** 03/07/2012