Organization
LIFESCAN CHICAGO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY SOTO (CREDENTIALING MANAGER)
(708) 452-6842
Entity
Organization
Contact information
Practice address
2242 W HARRISON ST, STE 100, CHICAGO, IL 60612-3515
(312) 243-3200
(312) 243-5759
Mailing address
2242 W HARRISON ST, STE 100, CHICAGO, IL 60612-3515
(312) 243-3200
(312) 243-5759
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
05/23/2005
Last updated
05/06/2009
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