Elite Provider Group PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELITE PROVIDER GROUP PC

Practice address

5900 Waldon Rd Ste a
Clarkston, MI 48346-4806

Phone

(248) 625-7890

NPI assigned

Jun 20, 2025

Last updated

Sep 4, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Crystal Chandler

Title

Authorized Official

Phone

(810) 424-2136

Specialties & licenses 3

Addresses

Tax ID family

Elite Provider Group PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Elite Provider Group PC

  • Internal Medicine Physician
  • Burton, MI
  • NPI 1083501217
  NPD tax ID
• Elite Provider Group PC

  • Family Medicine Physician
  • Grand Blanc, MI
  • NPI 1205723434
  NPD tax ID
• Elite Provider Group PC

  • Family Medicine Physician
  • Burton, MI
  • NPI 1619864840
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1093602229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 WALDON RD STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464806",
            "telephone_number": "248-625-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PROVIDER GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "810-424-2136"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayleigh Ehlke, DPT
• Cheryl Anne Eick, LMSW
• Susan Einheuser, MSW,LMSW
• Chirine El Mokdad, MD
• Gino Elian
• Christa Lynne Ellingsworth, NP
• Roy F Elturk, D.D.S
• Candice Emeigh, PHARMD
• Emergency Neurosurgical Services, PLLC
• Empowerme Rehabilitation, LLC

• Family Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.