Organization Name: | HISTOLOGY CORP |
NPI Number: | 1043469745 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL J KELLY (PRESIDENT) |
Mailing Address: | 21 N Skokie Hwy Suite 202 Lake Bluff |
State: | IL US |
Postal Code: | 600441777 |
Phone Number: | 8475253147 |
Fax Number: | |
NPI Enumeration Date: | 09/17/2008 |
NPI Last Update Date: | 01/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246RH0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Pathology |
Taxonomy Specialization: | Histology |
Taxonomy Definition: |