Provider Demographics
NPI:1205875697
Name:ELRINGTON MEDICAL CENTER PLLC
Entity type:Organization
Organization Name:ELRINGTON MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ERROL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-255-6500
Mailing Address - Street 1:#6895 6895 RELIABLE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0001
Mailing Address - Country:US
Mailing Address - Phone:313-255-6500
Mailing Address - Fax:313-255-3671
Practice Address - Street 1:26611 W 7 MILE RD
Practice Address - Street 2:SUITE B
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2063
Practice Address - Country:US
Practice Address - Phone:313-255-6500
Practice Address - Fax:313-255-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060303208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108253431OtherBCBC BCN
MI418911OtherOMNICARE
MI7654078OtherAETNA
MI129448OtherCARE CHOICES
MI4443670Medicaid
MI101675OtherGREAT LAKES
MI7691OtherTOTAL HEALTH
MI821912OtherPROCARE
MIG34609OtherHAP
MI022488OtherMIDWEST
MI8107OtherHEALTH PLAN OF MI
MI101675OtherGREAT LAKES
MI0P33310Medicare PIN