Organization
PPG CLINICAL PATHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A PETTERCHAK M.D. (MEMBER/OWNER)
(314) 996-5218
Entity
Organization
Contact information
Practice address
3015 N BALLAS ROAD, DEPARTMENT OF PATHOLOGY, ST. LOUIS, MO 63131-2329
(630) 581-6523
(630) 472-9502
Mailing address
1200 HARGER ROAD, SUITE 408, OAK BROOK, IL 60523-1818
(630) 472-8800
(630) 472-9502
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Enumeration date
07/17/2014
Last updated
03/30/2023
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