Provider Demographics
NPI:1033687462
Name:GO DIAGNOSTICS INC
Entity Type:Organization
Organization Name:GO DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHALAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-410-2126
Mailing Address - Street 1:7514 SKOKIE BLVD STE 107B
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3377
Mailing Address - Country:US
Mailing Address - Phone:847-410-2126
Mailing Address - Fax:
Practice Address - Street 1:7514 SKOKIE BLVD STE 107B
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3377
Practice Address - Country:US
Practice Address - Phone:847-410-2126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-03
Last Update Date:2018-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory