Provider Demographics
NPI:1821318601
Name:ORTHOPEDIC ANALYSIS LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC ANALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HALLAB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-733-7121
Mailing Address - Street 1:2201 W CAMPBELL PARK DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4092
Mailing Address - Country:US
Mailing Address - Phone:312-733-7121
Mailing Address - Fax:312-733-7121
Practice Address - Street 1:2201 W CAMPBELL PARK DR
Practice Address - Street 2:SUITE 211
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4092
Practice Address - Country:US
Practice Address - Phone:312-733-7121
Practice Address - Fax:312-733-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14D2004596291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory