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Organization

OAK CREST LABORATORY SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RUSSELL JOHN GAMBINO JR. (PRESIDENT)
(708) 567-1231
Entity
Organization

Contact information

Practice address
1452 MERCHANT DR UNIT B, ALGONQUIN, IL 60102-5917
(708) 634-6180
(708) 634-6181
Mailing address
1452 MERCHANT DR UNIT B, ALGONQUIN, IL 60102-5917
(708) 634-6180
(708) 634-6181

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D0418588
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205876554
ANTHEM BLUE CROSS PPO
IL
Enumeration date
06/07/2006
Last updated
03/08/2024
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