Organization
NRI LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REYNALDO ILAGAN PRESIDENT (PRESIDENT)
(773) 773-6743
Entity
Organization
Contact information
Practice address
5960 N MILWAUKEE AVE, CHICAGO, IL 60646-5424
(773) 775-6743
(773) 775-6673
Mailing address
5960 N MILWAUKEE AVE, CHICAGO, IL 60646-5424
(773) 775-6743
(773) 775-6673
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D0646644
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001633071
BCBS - IL
IL
01
—
244163
HARMONY HEALTH PLAN
IL
Enumeration date
07/09/2005
Last updated
04/02/2010
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