Healthcare Provider Details

I. General information

NPI: 1003458100
Provider Name (Legal Business Name): ELEVATE CARE IRVING PARK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 N KEYSTONE AVE
CHICAGO IL
60641-2121
US

IV. Provider business mailing address

4655 W CHASE AVE
LINCOLNWOOD IL
60712-1605
US

V. Phone/Fax

Practice location:
  • Phone: 773-545-8700
  • Fax:
Mailing address:
  • Phone: 847-262-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MEIR MEYSTEL
Title or Position: CEO
Credential:
Phone: 773-368-5173