Organization
DOCTORS CLINICAL LABORATORY INC
Active
Organization
DOCTORS CLINICAL LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED SHUJAUDDIN (PRESIDENT)
(312) 448-8570
Entity
Organization
Contact information
Practice address
1685 WINNETKA CIR, ROLLING MEADOWS, IL 60008-1372
(312) 448-8570
Mailing address
6177 N LINCOLN AVE # 348, CHICAGO, IL 60659-2313
(312) 448-8570
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1167724
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630245
BLUE CROSS BLUE SHIELDS
IL
Enumeration date
03/19/2007
Last updated
10/01/2021
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