Provider Demographics
NPI:1972293876
Name:REMINGTON MOLECULAR MAYFAIR LLC
Entity Type:Organization
Organization Name:REMINGTON MOLECULAR MAYFAIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUAJARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-755-4106
Mailing Address - Street 1:3 GRANT SQ UNIT 145
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3351
Mailing Address - Country:US
Mailing Address - Phone:630-258-2384
Mailing Address - Fax:630-203-1643
Practice Address - Street 1:4351 N CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-1502
Practice Address - Country:US
Practice Address - Phone:630-325-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty