Provider Demographics
NPI:1225333230
Name:LL URGENT CARE LLC
Entity Type:Organization
Organization Name:LL URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREEM
Authorized Official - Middle Name:M
Authorized Official - Last Name:ELSHATORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-835-4422
Mailing Address - Street 1:12262 FORT BUFFALO CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12262 FORT BUFFALO CIR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2832
Practice Address - Country:US
Practice Address - Phone:703-864-9159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244445261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care