| Elemental Treatment Center Ltd | |
|
612 S Western Ave Apt 1 Chicago IL 60612-4682 | |
| (331) 330-9955 | |
| Not Available |
| Full Name | Elemental Treatment Center Ltd |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 612 S Western Ave Apt 1, Chicago, Illinois |
| Authorized Official Name and Position | Martins A Adeoye (CEO) |
| Authorized Official Contact | 3313309955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elemental Treatment Center Ltd 612 S Western Ave Apt 1 Chicago IL 60612-4682 Ph: (331) 330-9955 | Elemental Treatment Center Ltd 612 S Western Ave Apt 1 Chicago IL 60612-4682 Ph: (331) 330-9955 |
| NPI Number | 1598278749 |
|---|---|
| Provider Enumeration Date | 11/09/2017 |
| Last Update Date | 10/22/2024 |
| Certification Date | 10/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598278749 | NPI | - | NPPES |
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