Provider Demographics
NPI:1235138694
Name:NEO PATH SC
Entity type:Organization
Organization Name:NEO PATH SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:VEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADUANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-843-2000
Mailing Address - Street 1:520 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6110
Mailing Address - Country:US
Mailing Address - Phone:630-874-2542
Mailing Address - Fax:
Practice Address - Street 1:ST. ALEXIUS MEDICAL CENTER/PATHOLOGY DEPT
Practice Address - Street 2:1555 N. BARRINGTON RD.
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194
Practice Address - Country:US
Practice Address - Phone:847-843-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCA3490Medicare PIN
IL341360Medicare PIN