Provider Demographics
NPI:1316192248
Name:COMMUNITY PATHOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:COMMUNITY PATHOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-884-4632
Mailing Address - Street 1:PO BOX 5957
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5957
Mailing Address - Country:US
Mailing Address - Phone:877-852-4669
Mailing Address - Fax:
Practice Address - Street 1:2701 W 68TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-1813
Practice Address - Country:US
Practice Address - Phone:877-852-4669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1629042OtherBLUE CROSS BLUE SHIELD
ILIL1581Medicare PIN