Organization
SME PATHOLOGISTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAGUL TONSIENGSOM (PRESIDENT)
(630) 202-3134
Entity
Organization
Contact information
Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-3043
(815) 756-1521
Mailing address
PO BOX 3133, INDIANAPOLIS, IN 46206-3133
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634127
BCBS IL
IL
01
—
DB8469
RAILROAD MEDICARE
—
Enumeration date
10/20/2006
Last updated
07/24/2014
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