Organization
SHIFA MEDICAL LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAZHER M SHAH-KHAN (VICE PRESIDENT)
(630) 674-1974
Entity
Organization
Contact information
Practice address
5797 N LINCOLN AVE, CHICAGO, IL 60659-4722
(630) 674-1974
(773) 583-6301
Mailing address
PO BOX 597315, CHICAGO, IL 60659-7315
(630) 674-1974
(773) 583-6301
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/27/2021
Last updated
12/27/2021
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