Organization
CONSULTANTS IN LABORATORY MEDICINE AND PATHOLOGY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY THERESE UCKERMAN MD (OWNER)
(708) 229-5813
Entity
Organization
Contact information
Practice address
2800 W 95TH ST, DEPT OF PATHOLOGY, EVERGREEN PARK, IL 60805-2701
(708) 228-2875
Mailing address
PO BOX 5981, CAROL STREAM, IL 60197-5981
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083197
—
IL
Enumeration date
12/15/2006
Last updated
09/16/2024
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