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General NPI Number Information
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NPI Number | 1649359969
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Entity Type | Organization
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Legal Business Name | ELGIN CARE CENTER SC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 530 N MCLEAN BLVD
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City | ELGIN
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State | IL
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Zip | 60123-3275
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Country | US
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Telephone | 847-695-4800
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Fax | 847-695-4820
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Provider Business Mailing Address
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Address Line | 530 N MCLEAN BLVD
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City | ELGIN
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State | IL
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Zip | 60123-3275
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Country | US
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Telephone | 847-695-4800
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Fax | 847-695-4820
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Authorized Official
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Title or Position | VICE PRESIDENT & TREASURER
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Name | MRS. JOSEPHINE VELOSO FLORENTINO
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Credential | REGISTERED NURSE
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Telephone | 847-695-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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