MEDICARE: RESOLVE HEALTHCARE LLC DBA RESOLVE ENT

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	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1720652985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOLVE HEALTHCARE LLC DBA RESOLVE ENT

Provider Business Mailing Address
First Line	:	3228 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1106
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3228 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1106
Country	:	US
Telephone Number	:	312-480-1387
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MD
Name	:	SIVA KUMAR ELANGOVAN
Credential	:	MD
Telephone Number	:	312-480-1387

Provider Enumeration Date	:	05/13/2021
Last Update Date	:	11/12/2021

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