Provider Demographics
NPI:1053188599
Name:PRESCIENCE DIAGNOSTICS LLC
Entity type:Organization
Organization Name:PRESCIENCE DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FASHI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-453-2923
Mailing Address - Street 1:2545 W PETERSON AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4030
Mailing Address - Country:US
Mailing Address - Phone:773-453-2923
Mailing Address - Fax:872-710-0996
Practice Address - Street 1:2545 W PETERSON AVE STE 107
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4030
Practice Address - Country:US
Practice Address - Phone:773-453-2923
Practice Address - Fax:872-710-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory