Organization
ILLINIOS TECH LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAFEEQ UDDIN KHAJA (PRESIDENT)
(312) 952-3034
Entity
Organization
Contact information
Practice address
1818 SKOKIE BLVD, NORTHBROOK, IL 60062-4106
(312) 952-3034
Mailing address
8244 CENTRAL PARK AVE, SKOKIE, IL 60076-2909
(312) 952-3034
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
03/29/2022
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