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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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