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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