Provider Demographics
NPI:1760072292
Name:MOBILE HEALTH LABS LLC
Entity Type:Organization
Organization Name:MOBILE HEALTH LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NINEF
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ISHOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-804-3794
Mailing Address - Street 1:9012 N GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1425
Mailing Address - Country:US
Mailing Address - Phone:312-804-3794
Mailing Address - Fax:
Practice Address - Street 1:8031 N MILWAUKEE AVE FL 2
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2827
Practice Address - Country:US
Practice Address - Phone:312-804-3794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOBILE HEALTH LABS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory