MEDICARE: ELT4 NC, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1659995355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELT4 NC, P.C.

Provider Business Mailing Address
First Line	:	444 N MICHIGAN AVE STE 3400
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3980
Country	:	US
Telephone Number	:	919-627-5805
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 N MICHIGAN AVE STE 3400
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3980
Country	:	US
Telephone Number	:	919-627-5805
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. BIMAL SHAH
Credential	:	MD
Telephone Number	:	919-627-5805

Provider Enumeration Date	:	05/29/2020
Last Update Date	:	05/29/2020

Similar Medicare Providers

1457719973 — RETROFIT, INC.
Practice Location Address:

444 N MICHIGAN AVE STE 3400
CHICAGO, IL
60611-3980

Practice Phone: 630-248-3048
Practice Fax:

1629582721 — MELLISSA ARENA MS
Practice Location Address:

444 N MICHIGAN AVE STE 3400
CHICAGO, IL
60611-3980

Practice Phone: 312-766-6780
Practice Fax:

1063573319 — DR. RANDALL NORTON CLARK MD
Practice Location Address:

3980 CHICAGO DR SW STE 200
GRANDVILLE, MI
49418-1392

Practice Phone: 616-381-5181
Practice Fax: 616-381-5178

1487071213 — LIVING ROOTS LLC
Practice Location Address:

3980 CHICAGO DR SW , SUITE 100
GRANDVILLE, MI
49418-1392

Practice Phone: 616-575-8519
Practice Fax: 616-575-9078

1417482878 — SARA TUFFS
Practice Location Address:

1915 S RACINE AVE , APT 1
CHICAGO, IL
60608-3980

Practice Phone: 815-353-9424
Practice Fax:

1699431775 — KIRK ANDRIESSEN MSW
Practice Location Address:

3980 CHICAGO DR SW STE 114
GRANDVILLE, MI
49418-1392

Practice Phone: 616-209-9295
Practice Fax:

Directions to “ELT4 NC, P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.