Provider Demographics
NPI:1225729312
Name:GENE MATRIX LLC
Entity type:Organization
Organization Name:GENE MATRIX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAREK
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-302-9668
Mailing Address - Street 1:1375 W FULTON ST STE 545
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1128
Mailing Address - Country:US
Mailing Address - Phone:847-302-9668
Mailing Address - Fax:
Practice Address - Street 1:1375 W FULTON ST STE 545
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1128
Practice Address - Country:US
Practice Address - Phone:847-302-9668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory