Provider Demographics
NPI:1891727491
Name:ELMHURST MEDICAL PHYSICIANS, SC
Entity Type:Organization
Organization Name:ELMHURST MEDICAL PHYSICIANS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:GIGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-758-8885
Mailing Address - Street 1:1200 S YORK RD
Mailing Address - Street 2:3250
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5626
Mailing Address - Country:US
Mailing Address - Phone:630-758-8885
Mailing Address - Fax:630-758-8876
Practice Address - Street 1:1200 S YORK RD
Practice Address - Street 2:3250
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5626
Practice Address - Country:US
Practice Address - Phone:630-758-8885
Practice Address - Fax:630-758-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
923940Medicare ID - Type Unspecified