Michael W Elgersma

LBN: Michael W Elgersma
Michael W Elgersma is an health care organization with primary practice located at 262 Chatsworth Ave , Sugar Grove IL 60554-9475. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as the primary health care specialty. Michael W Elgersma can be contacted via phone (616) 644-1314, or through Elgersma, Nichael W via phone (616) 644-1314.

Contact Information

Primary practice address
262 Chatsworth Ave Sugar Grove IL 60554-9475
Phone: (616) 644-1314
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Elgersma, Nichael W
Phone: (616) 644-1314

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1710658844
LBN Legal business name Michael W Elgersma
DBA Doing business as
Authorized official Elgersma, Nichael W
Entity Organization
Organization subpart 1 No
Enumeration date Sep 28th, 2021
Last updated Oct 24th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710658844 NPPES
Other 1972946028 NPI
MEDICAID 366023638001 NPI

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