Organization
DOCTORS GENERAL LABORATORY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAHENDRA H PATEL (PRESIDENT)
(708) 599-5666
Entity
Organization
Contact information
Practice address
59 OGDEN AVE, CLARENDON HILLS, IL 60514-1026
(708) 599-5666
(708) 599-8737
Mailing address
9243 S ROBERTS RD, HICKORY HILLS, IL 60457-2079
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
001
IL
291U00000X
Clinical Medical Laboratory
Primary
14D0419924
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050000480
BLUE CROSS ID
IL
01
—
690009492
RAIL ROAD ID
IL
Enumeration date
08/02/2005
Last updated
07/21/2022
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