Provider Demographics
NPI:1619663226
Name:ALC DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:ALC DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-504-8423
Mailing Address - Street 1:2434 E DEMPSTER ST STE 110
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5339
Mailing Address - Country:US
Mailing Address - Phone:872-201-8642
Mailing Address - Fax:
Practice Address - Street 1:2434 E DEMPSTER ST STE 110
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5339
Practice Address - Country:US
Practice Address - Phone:872-201-8642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory