Provider Demographics
NPI:1033212014
Name:ELGIN SURGEONS LTD
Entity Type:Organization
Organization Name:ELGIN SURGEONS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:N
Authorized Official - Last Name:MICHELOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-776-1200
Mailing Address - Street 1:351 SHARON DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3412
Mailing Address - Country:US
Mailing Address - Phone:847-776-1200
Mailing Address - Fax:847-776-9400
Practice Address - Street 1:350 S 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-2248
Practice Address - Country:US
Practice Address - Phone:847-776-1200
Practice Address - Fax:847-776-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL674000Medicare ID - Type Unspecified
IL204672Medicare ID - Type Unspecified