Provider Demographics
NPI:1679850994
Name:INSITE LAB ADVISORS
Entity Type:Organization
Organization Name:INSITE LAB ADVISORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER LLC
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-900-6902
Mailing Address - Street 1:10 S RIVERSIDE PLZ
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-3728
Mailing Address - Country:US
Mailing Address - Phone:888-900-6902
Mailing Address - Fax:
Practice Address - Street 1:10 S RIVERSIDE PLZ
Practice Address - Street 2:SUITE 1800
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-3728
Practice Address - Country:US
Practice Address - Phone:888-900-6902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory