Provider Demographics
NPI:1073736724
Name:WASHINGTON, ELMER L (MD)
Entity Type:Individual
Prefix:
First Name:ELMER
Middle Name:L
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3301 KNOLLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2709
Mailing Address - Country:US
Mailing Address - Phone:708-957-7317
Mailing Address - Fax:708-747-3497
Practice Address - Street 1:233 W JOE ORR RD
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1744
Practice Address - Country:US
Practice Address - Phone:708-754-1044
Practice Address - Fax:708-747-3497
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine