Provider Demographics
NPI:1982356325
Name:SWIFT DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:SWIFT DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-410-3285
Mailing Address - Street 1:4320 W AUGUSTA BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-3430
Mailing Address - Country:US
Mailing Address - Phone:773-410-3285
Mailing Address - Fax:
Practice Address - Street 1:4320 W AUGUSTA BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-3430
Practice Address - Country:US
Practice Address - Phone:773-410-3285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center