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Organization

SOUTHWEST LABORATORY PHYSICIANS, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMER DOLA M.D. (PRESIDENT)
(708) 215-2341
Entity
Organization

Contact information

Practice address
1 INGALLS DR, HARVEY, IL 60426-3558
(708) 596-9833
Mailing address
DEPT 77-9288, CHICAGO, IL 60678-9288
(877) 861-9294

Taxonomy

Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01620233
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/30/2006
Last updated
09/11/2024
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