Provider Demographics
NPI:1124740758
Name:SMZ MEDICAL AND DIAGNOSTICS LLC
Entity type:Organization
Organization Name:SMZ MEDICAL AND DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAWARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-678-9009
Mailing Address - Street 1:1228 S LEO CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2388
Mailing Address - Country:US
Mailing Address - Phone:773-678-9009
Mailing Address - Fax:
Practice Address - Street 1:653 METROPOLITAN WAY
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4602
Practice Address - Country:US
Practice Address - Phone:773-678-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory