Organization
CONSULTANTS IN CLINICAL PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY THERESE UCKERMAN M.D. (OWNER)
(708) 229-5813
Entity
Organization
Contact information
Practice address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2701
(708) 228-2875
Mailing address
PO BOX 85443, CHICAGO, IL 60689-5443
(708) 235-1589
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036083197
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1632109
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/25/2006
Last updated
03/26/2026
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