Provider Demographics
NPI:1740177385
Name:KSP BIOSCRIPT LLC
Entity type:Organization
Organization Name:KSP BIOSCRIPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENSHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-690-8895
Mailing Address - Street 1:2008 W 119TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4818
Mailing Address - Country:US
Mailing Address - Phone:866-454-7267
Mailing Address - Fax:872-762-5326
Practice Address - Street 1:2008 W 119TH ST STE 7
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4818
Practice Address - Country:US
Practice Address - Phone:866-454-7267
Practice Address - Fax:872-762-5326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory