Provider Demographics
NPI:1598419244
Name:ALAK, BAHA M (PH D)
Entity Type:Individual
Prefix:DR
First Name:BAHA
Middle Name:M
Last Name:ALAK
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 N MILWAUKEE AVE LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-8002
Mailing Address - Country:US
Mailing Address - Phone:813-300-5868
Mailing Address - Fax:
Practice Address - Street 1:687 N MILWAUKEE AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-8002
Practice Address - Country:US
Practice Address - Phone:813-300-5868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory