Provider Demographics
NPI:1801523634
Name:HEALTHCARE MANAGEMENT CONSULTING AND STAFFING OF CHICAGO
Entity type:Organization
Organization Name:HEALTHCARE MANAGEMENT CONSULTING AND STAFFING OF CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CESARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLIGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-329-6545
Mailing Address - Street 1:2648 W GLENLAKE AVE APT 3C
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-2884
Mailing Address - Country:US
Mailing Address - Phone:773-329-6545
Mailing Address - Fax:
Practice Address - Street 1:2535 W PETERSON AVE STE 526
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4019
Practice Address - Country:US
Practice Address - Phone:773-329-6545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D2264781OtherCLIA