Elite Regenerative Medicine and Wound Clinic, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ELITE REGENERATIVE MEDICINE AND WOUND CLINIC, LLC

Practice address

380 E Northwest Hwy Ste 202
Des Plaines, IL 60016-2274

Phone

(817) 823-9669

NPI assigned

Dec 6, 2018

Last updated

Feb 21, 2019By 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

Noah Seitel

Title

Manager

Phone

(817) 823-9669

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550707200000",
    "number": "1265903942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8528 DAVIS BLVD # 134-301",
            "city": "N RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761828367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 E NORTHWEST HWY STE 202",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162274",
            "telephone_number": "817-823-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE REGENERATIVE MEDICINE AND WOUND CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2019-02-21",
        "status": "A",
        "authorized_official_last_name": "SEITEL",
        "authorized_official_first_name": "NOAH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-823-9669"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.