Healthcare Provider Details

I. General information

NPI: 1720652985
Provider Name (Legal Business Name): RESOLVE HEALTHCARE LLC DBA RESOLVE ENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3228 N LINCOLN AVE
CHICAGO IL
60657-1106
US

IV. Provider business mailing address

3228 N LINCOLN AVE
CHICAGO IL
60657-1106
US

V. Phone/Fax

Practice location:
  • Phone: 312-480-1387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: SIVA KUMAR ELANGOVAN
Title or Position: OWNER/MD
Credential: MD
Phone: 312-480-1387