Provider Demographics
NPI:1124623657
Name:TAAG GENETICS CORP.
Entity type:Organization
Organization Name:TAAG GENETICS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-394-3588
Mailing Address - Street 1:3710 ILLINOIS AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2421
Mailing Address - Country:US
Mailing Address - Phone:630-246-7777
Mailing Address - Fax:630-946-5555
Practice Address - Street 1:3710 ILLINOIS AVE UNIT A
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2421
Practice Address - Country:US
Practice Address - Phone:630-246-7777
Practice Address - Fax:630-946-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory