Provider Demographics
NPI:1407001324
Name:VIRTUAL PATHOLOGY PARTNERS, LLC
Entity Type:Organization
Organization Name:VIRTUAL PATHOLOGY PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTIMO
Authorized Official - Middle Name:G
Authorized Official - Last Name:CANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-884-4631
Mailing Address - Street 1:PO BOX 5991
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5991
Mailing Address - Country:US
Mailing Address - Phone:773-284-0904
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:773-884-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty