Provider Demographics
NPI:1922508696
Name:ELGIN METABOLIC CENTER LLC
Entity Type:Organization
Organization Name:ELGIN METABOLIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-697-0770
Mailing Address - Street 1:2400 BIG TIMBER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-7835
Mailing Address - Country:US
Mailing Address - Phone:847-697-0770
Mailing Address - Fax:847-697-0789
Practice Address - Street 1:2400 BIG TIMBER RD STE 200
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-7835
Practice Address - Country:US
Practice Address - Phone:847-697-0770
Practice Address - Fax:847-697-0789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty