Healthcare Provider Details

I. General information

NPI: 1285745125
Provider Name (Legal Business Name): ELGIN FAMILY PHYSICIANS, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 N AIRLITE ST STE 130
ELGIN IL
60123-4991
US

IV. Provider business mailing address

87 N AIRLITE ST STE 130
ELGIN IL
60123-4991
US

V. Phone/Fax

Practice location:
  • Phone: 847-888-3661
  • Fax: 847-888-9964
Mailing address:
  • Phone: 847-888-3661
  • Fax: 847-888-9964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042006899
License Number StateIL

VIII. Authorized Official

Name: MS. CHRIS MCCARTHY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 847-888-3661