Provider Demographics
NPI:1730483538
Name:ASSURED DIAGNOSTIC TESTING,INC.
Entity Type:Organization
Organization Name:ASSURED DIAGNOSTIC TESTING,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE- PRES.
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-704-0997
Mailing Address - Street 1:380 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 320 B-2
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2290
Mailing Address - Country:US
Mailing Address - Phone:847-768-1090
Mailing Address - Fax:847-768-7665
Practice Address - Street 1:380 E NORTHWEST HWY
Practice Address - Street 2:SUITE 320 B-2
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2290
Practice Address - Country:US
Practice Address - Phone:847-768-1090
Practice Address - Fax:847-768-7665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory