Healthcare Provider Details

I. General information

NPI: 1649476714
Provider Name (Legal Business Name): ELITE HEALTH PROVIDERS, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 WASHINGTON AVE
HIGHWOOD IL
60040-1122
US

IV. Provider business mailing address

130 WASHINGTON AVE
HIGHWOOD IL
60040-1122
US

V. Phone/Fax

Practice location:
  • Phone: 847-374-8400
  • Fax: 847-374-8404
Mailing address:
  • Phone: 847-374-8400
  • Fax: 847-374-8404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: SATVINDER S. DHESI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 773-454-4556