Provider Demographics
NPI:1194594648
Name:ELITE MED URGENT CARE LLC
Entity type:Organization
Organization Name:ELITE MED URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDELKHALIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:QASEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-380-8008
Mailing Address - Street 1:9634 S ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-2238
Mailing Address - Country:US
Mailing Address - Phone:708-380-8888
Mailing Address - Fax:
Practice Address - Street 1:9634 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2238
Practice Address - Country:US
Practice Address - Phone:708-380-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care