Provider Demographics
NPI:1912379942
Name:SEEMA ELAHI, M.D., INC.
Entity Type:Organization
Organization Name:SEEMA ELAHI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LYSANDROU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-588-7733
Mailing Address - Street 1:450 E 22ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6175
Mailing Address - Country:US
Mailing Address - Phone:773-588-7733
Mailing Address - Fax:773-588-7340
Practice Address - Street 1:450 E 22ND ST STE 100
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6175
Practice Address - Country:US
Practice Address - Phone:630-673-5757
Practice Address - Fax:908-605-4974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084250207R00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084250Medicaid
IL036084250Medicaid