Organization
OAK CREST LABORATORY SERVICES, INC
Active
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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