Organization
OA LABS CLINIC LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS MATARAGAS MD (DIRECTOR OF MEDICINE)
(630) 235-0220
Entity
Organization
Contact information
Practice address
6321 FAIRVIEW AVE STE B, WESTMONT, IL 60559-2886
(630) 235-0220
(985) 370-2321
Mailing address
6321 FAIRVIEW AVE STE B, WESTMONT, IL 60559-2886
(630) 235-0220
(985) 370-2321
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
336070137
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H63416
—
IL
Enumeration date
02/16/2018
Last updated
06/16/2018
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