Provider Demographics
NPI:1497076392
Name:ELMHURST MEMORIAL HEALTHCARE
Entity Type:Organization
Organization Name:ELMHURST MEMORIAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LURYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:331-221-9055
Mailing Address - Street 1:ELMHURST MEMORIAL HEALTHCARE DEPARTMENT 4585
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-4585
Mailing Address - Country:US
Mailing Address - Phone:331-221-5678
Mailing Address - Fax:331-221-2706
Practice Address - Street 1:172 E SCHILLER ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2816
Practice Address - Country:US
Practice Address - Phone:331-221-0000
Practice Address - Fax:331-221-2706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCM0811OtherRR MEDICARE
ILCM0811OtherRR MEDICARE
IL215281Medicare PIN