| Ljt Therapeutics | |
|
1130 S Canal St Ste 1177 Chicago IL 60607-5058 | |
| (773) 600-6667 | |
| Not Available |
| Full Name | Ljt Therapeutics |
|---|---|
| Speciality | Clinic/Center |
| Location | 1130 S Canal St Ste 1177, Chicago, Illinois |
| Authorized Official Name and Position | Lahaji Thomas (OWNER) |
| Authorized Official Contact | 7736006667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ljt Therapeutics 701 Market St Suite 110 Pmb 1983 Saint Louis MO 63101-1824 Ph: () - | Ljt Therapeutics 1130 S Canal St Ste 1177 Chicago IL 60607-5058 Ph: (773) 600-6667 |
| NPI Number | 1013663368 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 06/22/2025 |
| Certification Date | 06/22/2025 |
| Medicare PECOS PAC ID | 4688111651 |
|---|---|
| Medicare Enrollment ID | O20240808000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013663368 | NPI | - | NPPES |
| Provider Name | Lahaji Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689255085 PECOS PAC ID: 5597202564 Enrollment ID: I20240808000546 |
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