Organization
JUSTICE MED LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE CHRISTOU MD (MANAGER)
(708) 563-0330
Entity
Organization
Contact information
Practice address
9050 W 81ST ST, JUSTICE, IL 60458-1350
(708) 594-3500
(708) 594-5171
Mailing address
9050 W 81ST ST, JUSTICE, IL 60458-1350
(708) 594-3500
(708) 594-5171
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D0982127
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01629953
BCBS
IL
Enumeration date
01/18/2007
Last updated
09/30/2008
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