Organization
OPTIMA MEDICAL CENTER INC
Active
Organization
OPTIMA MEDICAL CENTER INC
Active
Other names
Optima Clinical Labs
Organization subpart
No
Provider details
NPI number
Authorized official
IMTIYAZ PASHA (OWNER)
(773) 766-1090
Entity
Organization
Contact information
Practice address
4539 N SHERIDAN RD, CHICAGO, IL 60640-5618
(773) 766-1090
Mailing address
6759 N CLARK ST, CHICAGO, IL 60626-3220
(773) 766-1090
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
525871
OTHER
IL
Enumeration date
04/12/2022
Last updated
11/16/2022
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