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General NPI Number Information
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NPI Number | 1558068700
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Entity Type | Organization
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Legal Business Name | ELDER CARE PHYSICIANS LLC
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/12/2023
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Provider Practice Location Address
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Address Line | 1S072 LUTHER AVE
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City | LOMBARD
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State | IL
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Zip | 60148-4164
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Country | US
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Telephone | 872-888-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 384 E 17TH PL
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City | LOMBARD
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State | IL
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Zip | 60148-4926
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Country | US
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Telephone | 872-888-2444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAHAAB UDDIN
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Credential | MD
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Telephone | 872-888-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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