Organization
WESTCHESTER DIAGNOSTIC LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE G MORAN MD (PRESIDENT)
(708) 492-0502
Entity
Organization
Contact information
Practice address
2225 ENTERPRISE DR, SUITE 2511, WESTCHESTER, IL 60154-5814
(708) 486-0076
(708) 486-0080
Mailing address
3183 PAYSPHERE CIR, CHICAGO, IL 60674-0031
(708) 492-0502
(708) 492-0565
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
11/27/2007
Last updated
04/20/2008
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