Provider Demographics
NPI:1285712844
Name:PATHOLOGY PHYSICIAN SERVICES, LTD
Entity type:Organization
Organization Name:PATHOLOGY PHYSICIAN SERVICES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DILIPKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DHARKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-846-7540
Mailing Address - Street 1:PO BOX 5161
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60567-5161
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:645 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644
Practice Address - Country:US
Practice Address - Phone:773-626-4300
Practice Address - Fax:773-626-0648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF7349OtherRAILROAD MEDICARE
IL1932100OtherBCBS IL
DF7349OtherRAILROAD MEDICARE