Provider Demographics
NPI:1902416936
Name:CHICAGO LAB SERVICES INC
Entity Type:Organization
Organization Name:CHICAGO LAB SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIB
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:630-788-0870
Mailing Address - Street 1:7422 N WESTERN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-1707
Mailing Address - Country:US
Mailing Address - Phone:773-274-3418
Mailing Address - Fax:773-856-6829
Practice Address - Street 1:7422 N WESTERN AVE STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-1707
Practice Address - Country:US
Practice Address - Phone:773-274-3418
Practice Address - Fax:773-856-6829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical PathologyGroup - Single Specialty