Provider Demographics
NPI:1285230987
Name:HEMO-STAT PHLEBOTOMY SERVICES LLC
Entity Type:Organization
Organization Name:HEMO-STAT PHLEBOTOMY SERVICES LLC
Other - Org Name:YEAR
Other - Org Type:Other Name
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:LAKESA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-516-6243
Mailing Address - Street 1:14721 BEACHVIEW TERRECE
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419
Mailing Address - Country:US
Mailing Address - Phone:708-516-6243
Mailing Address - Fax:
Practice Address - Street 1:14721 BEACHVIEW TERRECE
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419
Practice Address - Country:US
Practice Address - Phone:708-573-1665
Practice Address - Fax:708-996-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty