Organization
SCH LABORATORY PHYSICIANS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOREN E DARDI MD (PRESIDENT)
(773) 878-8200
Entity
Organization
Contact information
Practice address
5145 N CALIFORNIA AVE, CHICAGO, IL 60625-3661
(773) 878-8200
Mailing address
5145 N CALIFORNIA AVE, CHICAGO, IL 60625-3661
(773) 878-8200
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634575
BLUE SHIELD ILLINOIS
IL
01
—
DC0045
PALMETTO GBA
IL
Enumeration date
08/14/2006
Last updated
08/22/2020
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