Provider Demographics
NPI:1790403814
Name:ELITE HEALTH CONSULTING CO
Entity Type:Organization
Organization Name:ELITE HEALTH CONSULTING CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:IM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:224-351-8103
Mailing Address - Street 1:914 N LAKE ST # 10
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1324
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:914 N LAKE ST # 10
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1324
Practice Address - Country:US
Practice Address - Phone:224-351-8103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty