| Elgin Surgicare Llc | |
|
521 W Chicago Ave East Chicago IN 46312-3206 | |
| (630) 345-0834 | |
| Not Available |
| Full Name | Elgin Surgicare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 521 W Chicago Ave, East Chicago, Indiana |
| Authorized Official Name and Position | Tania Khamoo (ADMINISTRATOR) |
| Authorized Official Contact | 7733096740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elgin Surgicare Llc 4941 N Kedzie Ave Chicago IL 60625-5009 Ph: (773) 509-9099 | Elgin Surgicare Llc 521 W Chicago Ave East Chicago IN 46312-3206 Ph: (630) 345-0834 |
| NPI Number | 1124556444 |
|---|---|
| Provider Enumeration Date | 05/31/2017 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124556444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1952663593 (Indiana) | Secondary |
| 207R00000X | Internal Medicine | 01077720A (Indiana) | Primary |
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