| Oa Labs Clinic LLC. | |
|
6321 Fairview Ave Ste B Westmont IL 60559-2886 | |
| (630) 235-0220 | |
| (985) 370-2321 |
| Full Name | Oa Labs Clinic LLC. |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 6321 Fairview Ave Ste B, Westmont, Illinois |
| Authorized Official Name and Position | Nicholas Mataragas (DIRECTOR OF MEDICINE) |
| Authorized Official Contact | 6302350220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oa Labs Clinic LLC. 6321 Fairview Ave Ste B Westmont IL 60559-2886 Ph: (630) 235-0220 | Oa Labs Clinic LLC. 6321 Fairview Ave Ste B Westmont IL 60559-2886 Ph: (630) 235-0220 |
| NPI Number | 1538669510 |
|---|---|
| Provider Enumeration Date | 02/16/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538669510 | NPI | - | NPPES |
| H63416 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 336070137 (Illinois) | Primary |
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