Provider Demographics
NPI:1992013759
Name:ELKADY, EHAB M
Entity Type:Individual
Prefix:
First Name:EHAB
Middle Name:M
Last Name:ELKADY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5764 S ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-1643
Mailing Address - Country:US
Mailing Address - Phone:773-284-0888
Mailing Address - Fax:773-284-0880
Practice Address - Street 1:851 BAY RIDGE AVE APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5742
Practice Address - Country:US
Practice Address - Phone:518-421-5224
Practice Address - Fax:718-576-1732
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist