Organization
MEDICARE LABORATORY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYESHA KHAN (PRESIDENT)
(773) 414-9035
Entity
Organization
Contact information
Practice address
5659 N LINCOLN AVE, CHICAGO, IL 60659-4957
(773) 414-9035
Mailing address
5659 N LINCOLN AVE, CHICAGO, IL 60659-4957
(773) 414-9035
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/29/2021
Last updated
04/05/2022
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