Organization
CONSULTANTS IN PATHOLOGY SC
Active
Other names
CIP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A FRITSCH MD (PRESIDENT)
(219) 873-3130
Entity
Organization
Contact information
Practice address
20201 CRAWFORD AVE, OLYMPIA FIELDS, IL 60461-1010
(708) 747-4000
(219) 359-2232
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
042006819
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630255
BC/BS
IL
05
—
XXXXXXXXX-46361-01
—
IL
05
—
XXXXXXXXX-46361-02
—
IL
Enumeration date
08/25/2005
Last updated
01/23/2024
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