Provider Demographics
NPI:1598302077
Name:ENHANCE MEDICAL PLLC
Entity type:Organization
Organization Name:ENHANCE MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO-MGR
Authorized Official - Prefix:
Authorized Official - First Name:CHANELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-970-2484
Mailing Address - Street 1:280 W ARMY TRAIL ROAD
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-9368
Mailing Address - Country:US
Mailing Address - Phone:630-580-0027
Mailing Address - Fax:630-523-0033
Practice Address - Street 1:280 W ARMY TRAIL ROAD
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-9368
Practice Address - Country:US
Practice Address - Phone:239-260-0530
Practice Address - Fax:630-523-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty