Elsen, John Robert

Elsen, John Robert is an individual health care provider with primary practice located at 2850 W 95Th St Suite 403, Evergreen Park IL 60805-2735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Elsen, John Robert can be contacted via phone (708) 423-2662.

Contact Information

Primary practice address
2850 W 95Th St Suite 403 Evergreen Park IL 60805-2735
Phone: (708) 423-2662
Fax: (708) 422-7264
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-085149 Illinois

Profile Details

NPI number 1437260940
LBN Legal business name Elsen, John Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Mar 11th, 2021 - about 4 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 1437260940 NPPES
Illinois Other 01621926 BLUE CROSS BLUE SHIELD
Illinois Other 080132270 BLUE CROSS BLUE SHIELD

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