Organization
NISA ESTATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHOUDHRY I TARAR (OWNER)
(773) 817-7965
Entity
Organization
Contact information
Practice address
5757 N LINCOLN AVE STE 19, CHICAGO, IL 60659-4729
(773) 817-7965
Mailing address
5757 N LINCOLN AVE STE 19, CHICAGO, IL 60659-4729
(773) 817-7965
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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