Provider Demographics
NPI:1952326019
Name:ELAHI, SEEMA (MD)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:
Last Name:ELAHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6374 N LINCOLN AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1275
Mailing Address - Country:US
Mailing Address - Phone:773-588-7733
Mailing Address - Fax:773-588-7340
Practice Address - Street 1:6374 N LINCOLN AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1275
Practice Address - Country:US
Practice Address - Phone:773-588-7733
Practice Address - Fax:773-588-7340
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084250Medicaid
ILP00196006OtherMEDICARE RR-GA
ILK07715Medicare PIN
K52934Medicare PIN
IL036084250Medicaid