Organization
ASE MEDICAL INSTITUTE
Active
Other names
Immediate Diagnostics, L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M. MANDELA LEE MD, PHD(C), CLS(AAB) (OWNER / CEO)
(877) 404-0704
Entity
Organization
Contact information
Practice address
344 VICTORY DR, PARK FOREST, IL 60466-2003
(708) 490-3340
Mailing address
344 VICTORY DR, PARK FOREST, IL 60466-2003
(877) 404-0704
(877) 505-2724
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
08/05/2024
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