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General NPI Number Information
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NPI Number | 1437705829
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Entity Type | Individual
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Provider Name | CARLI P ELMORE
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Gender | Female
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 345 N MORGAN ST # 575
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City | CHICAGO
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State | IL
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Zip | 60607-1322
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Country | US
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Telephone | 773-590-3540
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Fax |
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Provider Business Mailing Address
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Address Line | 345 N MORGAN ST
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City | CHICAGO
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State | IL
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Zip | 60607-1322
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Country | US
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Telephone | 773-590-3540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085-007155
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License Number State | IL
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