Provider Demographics
NPI:1285887372
Name:TZAM DIAGNOSTICS LLC
Entity type:Organization
Organization Name:TZAM DIAGNOSTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HONGJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-256-3238
Mailing Address - Street 1:1880 HOLSTE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-7716
Mailing Address - Country:US
Mailing Address - Phone:847-256-3238
Mailing Address - Fax:847-256-3239
Practice Address - Street 1:1880 HOLSTE RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-7716
Practice Address - Country:US
Practice Address - Phone:847-256-3238
Practice Address - Fax:847-256-3239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14D1039167291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1662OtherMEDICARE PTAN
IL01629156OtherBCBS PROVIDER #
IL=========OtherFEIN