Provider Demographics
NPI:1609802198
Name:ASSOCIATED PATHOLOGY CONSULTANTS-ELMHURST, S.C.
Entity Type:Organization
Organization Name:ASSOCIATED PATHOLOGY CONSULTANTS-ELMHURST, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:CANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:331-221-0556
Mailing Address - Street 1:PO BOX 3680
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61612-3680
Mailing Address - Country:US
Mailing Address - Phone:630-834-0610
Mailing Address - Fax:
Practice Address - Street 1:155 E BRUSH HILL RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5658
Practice Address - Country:US
Practice Address - Phone:630-834-0610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02215591OtherBLUE CROSS BLUE SHIELD
ILN8236OtherRAILROAD MEDICARE
ILN8236OtherRAILROAD MEDICARE