Provider Demographics
NPI:1063181774
Name:CARE CLINICAL LAB INC
Entity type:Organization
Organization Name:CARE CLINICAL LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:UNKNOWN
Authorized Official - Middle Name:
Authorized Official - Last Name:AFROZ KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:872-352-1409
Mailing Address - Street 1:4055 OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3453
Mailing Address - Country:US
Mailing Address - Phone:847-565-8230
Mailing Address - Fax:
Practice Address - Street 1:4055 OAKTON ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3453
Practice Address - Country:US
Practice Address - Phone:847-565-8230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory