National Provider Identifier Database

DIAGNOSTIC MEDICAL LABORATORY INC
Laboratory Management


Contact Information

DIAGNOSTIC MEDICAL LABORATORY, INC.
4554 N. BROADWAY STREET
SUITE 317
CHICAGO, IL60640-5642
Phone: 773-255-4959
Fax: 773-506-0269
Website:
Specialty Taxonomy Code
* Laboratory Management 246QL0900X

* Indicates primary specialty

NPI Profile & details for DIAGNOSTIC MEDICAL LABORATORY, INC.

NPI Number 1376685016
Legal business name
LBN
DIAGNOSTIC MEDICAL LABORATORY, INC.
Authorized official JOSEPH TENGBEH - (LABORATORY DIRECTOR AND OWNER)
Entity Organization
Organization subpart No
Enumeration date 02/12/2007
Last updated 02/22/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • IL Medicaid: 20388576001

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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