Healthcare Provider Details

I. General information

NPI: 1346930617
Provider Name (Legal Business Name): ELHAM SOLTANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOYOLA UNIVERSITY MEDICAL CENTER BLDG. 108
MAYWOOD IL
60153
US

IV. Provider business mailing address

LOYOLA UNIVERSITY MEDICAL CENTER BLDG. 108
MAYWOOD IL
60153
US

V. Phone/Fax

Practice location:
  • Phone: 708-216-6200
  • Fax: 708-216-6840
Mailing address:
  • Phone: 708-216-6200
  • Fax: 708-216-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1346930617
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: