Provider Demographics
NPI:1811472186
Name:NANI LAB LLC
Entity type:Organization
Organization Name:NANI LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-573-5000
Mailing Address - Street 1:120 W 22ND ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 W 22ND ST STE 300
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4071
Practice Address - Country:US
Practice Address - Phone:630-974-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory