Provider Demographics
NPI:1588280622
Name:RADIANCE BIOSCIENCES & CONSULTANCY LLC
Entity type:Organization
Organization Name:RADIANCE BIOSCIENCES & CONSULTANCY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIVAKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-995-3722
Mailing Address - Street 1:1240 IROQUOIS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8538
Mailing Address - Country:US
Mailing Address - Phone:630-995-3722
Mailing Address - Fax:630-995-3739
Practice Address - Street 1:1240 IROQUOIS AVE STE 300
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8538
Practice Address - Country:US
Practice Address - Phone:630-995-3722
Practice Address - Fax:630-995-3739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory