Organization
K52 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATIMA SAMREEN (MANAGER)
(312) 532-1885
Entity
Organization
Contact information
Practice address
4325 N JESTERS CT, STE 9, PEORIA, IL 61614
(312) 532-1885
Mailing address
1815 E CAMP MCDONALD RD, MOUNT PROSPECT, IL 60056-1723
(312) 730-7860
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/23/2022
Last updated
04/07/2022
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