Organization
GABACHIEF MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN J COSTELLO (CEO)
(708) 420-0063
Entity
Organization
Contact information
Practice address
8343 W LAWRENCE AVE, NORRIDGE, IL 60706-3129
(708) 420-0063
Mailing address
4916 N CRESCENT AVE, NORRIDGE, IL 60706-3108
(708) 420-0063
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
203.001595
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14D2209774
—
IL
Enumeration date
08/16/2013
Last updated
12/07/2021
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