| K52 LLC | |
|
4325 N Jesters Ct Ste 9 Peoria IL 61614 | |
| (312) 532-1885 | |
| Not Available |
| Full Name | K52 LLC |
|---|---|
| Speciality | Clinical Medical Laboratory |
| Location | 4325 N Jesters Ct, Peoria, Illinois |
| Authorized Official Name and Position | Fatima Samreen (MANAGER) |
| Authorized Official Contact | 3125321885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| K52 LLC 1815 E Camp Mcdonald Rd Mount Prospect IL 60056-1723 Ph: (312) 730-7860 | K52 LLC 4325 N Jesters Ct Ste 9 Peoria IL 61614 Ph: (312) 532-1885 |
| NPI Number | 1477205292 |
|---|---|
| Provider Enumeration Date | 01/23/2022 |
| Last Update Date | 04/07/2022 |
| Certification Date | 03/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477205292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Secondary |
| 291U00000X | Clinical Medical Laboratory | () | Primary |
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