Provider Demographics
NPI:1578223632
Name:HANNAN LAB INC
Entity Type:Organization
Organization Name:HANNAN LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED HYDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMA KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-818-8166
Mailing Address - Street 1:2725 W BALMORAL AVE APT 2E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3232
Mailing Address - Country:US
Mailing Address - Phone:312-818-8166
Mailing Address - Fax:
Practice Address - Street 1:6954 W TOUHY AVE STE 201
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4535
Practice Address - Country:US
Practice Address - Phone:312-818-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory