Provider Demographics
NPI:1447915384
Name:MEDWIN LABS INC
Entity type:Organization
Organization Name:MEDWIN LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:224-388-1511
Mailing Address - Street 1:5251 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-4656
Mailing Address - Country:US
Mailing Address - Phone:773-865-9587
Mailing Address - Fax:
Practice Address - Street 1:5251 N CENTRAL AVE # 30065
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-4656
Practice Address - Country:US
Practice Address - Phone:224-388-1511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory