Provider Demographics
NPI:1538570528
Name:DES PLAINES CLINICAL LAB INC
Entity type:Organization
Organization Name:DES PLAINES CLINICAL LAB INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QADEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-699-7100
Mailing Address - Street 1:8833 GROSS POINT RD STE 308
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1859
Mailing Address - Country:US
Mailing Address - Phone:847-699-7100
Mailing Address - Fax:847-699-7797
Practice Address - Street 1:8833 GROSS POINT RD STE 308
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1859
Practice Address - Country:US
Practice Address - Phone:847-699-7100
Practice Address - Fax:847-699-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1402075610291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory