Provider Demographics
NPI:1912650342
Name:DUPAGE LABS LLC
Entity type:Organization
Organization Name:DUPAGE LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHOAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-400-5152
Mailing Address - Street 1:1800 W HAWTHORNE LN STE 205
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1863
Mailing Address - Country:US
Mailing Address - Phone:630-869-0835
Mailing Address - Fax:
Practice Address - Street 1:1800 W HAWTHORNE LN STE 205
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-1863
Practice Address - Country:US
Practice Address - Phone:630-869-0835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory