MEDICARE: ELITE HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070012425	IL
2	111N00000X	Chiropractor	038009474	IL

General Provider Information

NPI Number	:	1417106634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE HEALTHCARE

Provider Business Mailing Address
First Line	:	2732 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-7431
Country	:	US
Telephone Number	:	312-235-6773
Fax Number	:

Provider Business Practice Location Address
First Line	:	2732 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-7431
Country	:	US
Telephone Number	:	312-235-6773
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. JULIE KRITZ
Credential	:
Telephone Number	:	312-235-6773

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	02/02/2016

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Directions to “ELITE HEALTHCARE ” Practice Location

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