Provider Demographics
NPI:1134201130
Name:PATHOLOGY CONSULTANTS, S.C.
Entity type:Organization
Organization Name:PATHOLOGY CONSULTANTS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTUSEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-587-0193
Mailing Address - Street 1:PO BOX 1048
Mailing Address - Street 2:DEPT 1000
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-7048
Mailing Address - Country:US
Mailing Address - Phone:847-495-1617
Mailing Address - Fax:
Practice Address - Street 1:300 RANDALL RD
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4200
Practice Address - Country:US
Practice Address - Phone:630-587-0193
Practice Address - Fax:630-587-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04515197OtherBLUE SHIELD
IL720330Medicare ID - Type Unspecified