Provider Demographics
NPI:1154624799
Name:LABPRO INC
Entity type:Organization
Organization Name:LABPRO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LATINIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-527-6100
Mailing Address - Street 1:7444 W WILSON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60706-4549
Mailing Address - Country:US
Mailing Address - Phone:630-548-7887
Mailing Address - Fax:708-831-4253
Practice Address - Street 1:7444 W WILSON AVE STE 103
Practice Address - Street 2:
Practice Address - City:HARWOOD HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60706-4549
Practice Address - Country:US
Practice Address - Phone:630-548-7887
Practice Address - Fax:708-831-4253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D2015890OtherCLIA#
IL14D2025730OtherCLIA#