Provider Demographics
NPI:1760072292
Name:MOBILE HEALTH LABS LLC
Entity type:Organization
Organization Name:MOBILE HEALTH LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NINEF
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ISHOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-804-3794
Mailing Address - Street 1:2644 DEMPSTER ST STE 202
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-8431
Mailing Address - Country:US
Mailing Address - Phone:224-361-3054
Mailing Address - Fax:224-875-3040
Practice Address - Street 1:2644 DEMPSTER ST STE 202
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-8431
Practice Address - Country:US
Practice Address - Phone:224-361-3054
Practice Address - Fax:224-875-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory