Organization
MCHENRY LABORATORY SERVICES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA WELDER (GENERAL MANAGER)
(847) 509-9779
Entity
Organization
Contact information
Practice address
7531 S STONY ISLAND AVE, CHICAGO, IL 60649-3954
(773) 947-2400
Mailing address
306 ERA DR, NORTHBROOK, IL 60062-1834
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636129
BCBS IL
IL
01
—
DE6591
RAILROAD MEDICARE
—
Enumeration date
08/26/2008
Last updated
08/26/2008
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