Elite Medical Group

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ELITE MEDICAL GROUP

Practice address

3002 Gill St
Bloomington, IL 61704-3438

Phone

(309) 663-4443

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Craig Mathieson

Title

Partner

Phone

(309) 663-4443

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356560999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617020710",
            "telephone_number": "309-663-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 GILL ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043438",
            "telephone_number": "309-663-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHIESON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "309-663-4443"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ragheb El Assouad
• Elger Dental, LLC
• Anthony Mitchell Elger, DMD
• Nicole Eileen Elger, D.M.D.
• Elite Chiropractic and Rehabilitation Center, LTD.
• Elizabeth Heid Counseling Services PLLC
• Tate Eller, PHARMD
• Jordan S Elliott
• Ellis Therapeutic Services
• Melody Joyce Ellis

• Durable Medical Equipment & Medical Supplies in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.