Organization
CYTOGENETICS CONSULTANTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI L BAKKER (ADMINISTRATOR)
(312) 735-0976
Entity
Organization
Contact information
Practice address
2825 N HALSTED ST, CHICAGO, IL 60657-5105
(773) 472-4949
(773) 871-5221
Mailing address
2825 N HALSTED ST, CHICAGO, IL 60657-5105
(773) 472-4949
(773) 871-5221
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D0950847
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D0950847
CLIA
IL
Enumeration date
01/07/2009
Last updated
01/07/2009
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