Provider Demographics
NPI:1851485965
Name:PREFERRED DIAGNOSTICS., INC.
Entity Type:Organization
Organization Name:PREFERRED DIAGNOSTICS., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-322-2438
Mailing Address - Street 1:1103N. CROSBY ST. STE. A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2405
Mailing Address - Country:US
Mailing Address - Phone:847-322-2438
Mailing Address - Fax:312-624-7989
Practice Address - Street 1:1103 N CROSBY ST # A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2405
Practice Address - Country:US
Practice Address - Phone:847-322-2438
Practice Address - Fax:312-624-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635845OtherBLUE CROSSB BLUE SHIELD
IL01635845OtherBLUE CROSSB BLUE SHIELD
IL212904Medicare ID - Type UnspecifiedCOOK COUNTY
IL01635845OtherBLUE CROSSB BLUE SHIELD