Elmahboub, Asim
Elmahboub, Asim is an individual health care provider with primary practice located at 200 Health Care Dr , Greenville IL 62246-1154. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Adolescent Medicine is his primary health care specialty. Elmahboub, Asim can be contacted via phone (618) 664-1230.Contact Information
Primary practice address
200 Health Care Dr
Greenville IL 62246-1154
Phone: (618) 664-1230
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036.092411 | Illinois |
Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036.092411 | Illinois |
Allopathic & Osteopathic Physicians / Adolescent Medicine | 207RA0000X | 036-092411 | Illinois |
Profile Details
NPI number | 1316984859 |
---|---|
LBN Legal business name | Elmahboub, Asim |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 1st, 2006 |
Last updated | May 10th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1316984859 | NPPES |
Illinois | Other | L51016 | MEDICARE PIN FOR GOUP #645650 |
Illinois | MEDICAID | 036092477 | MEDICARE PIN FOR GOUP #645650 |
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