Healthcare Provider Details

I. General information

NPI: 1205875697
Provider Name (Legal Business Name): ELRINGTON MEDICAL CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26611 W 7 MILE RD SUITE B
REDFORD MI
48240-2063
US

IV. Provider business mailing address

#6895 6895 RELIABLE PARKWAY
CHICAGO IL
60686-0001
US

V. Phone/Fax

Practice location:
  • Phone: 313-255-6500
  • Fax: 313-255-3671
Mailing address:
  • Phone: 313-255-6500
  • Fax: 313-255-3671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301060303
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301060303
License Number StateMI

VIII. Authorized Official

Name: ERROL ELRINGTON
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 313-255-6500