Elt4 NC, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ELT4 NC, P.C.

Practice address

444 N Michigan Ave Ste 3400
Chicago, IL 60611-3980

Phone

(919) 627-5805

NPI assigned

May 29, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Bimal Shah, MD

Title

Director

Phone

(919) 627-5805

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1659995355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N MICHIGAN AVE STE 3400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113980",
            "telephone_number": "919-627-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N MICHIGAN AVE STE 3400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113980",
            "telephone_number": "919-627-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELT4 NC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BIMAL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-627-5805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elski LLC
• Diandra Elsner, OTR/L
• Elston Management Corporation
• Bethany Jean Elston, L.C.S.W.
• Dayna Ivy Elston
• Ali Rada Eltatawy, MD
• Abigail Rose Eltzroth
• John Elue, MD
• Srujana Eluri, D.D.S
• Crystal Fatameh Elusta

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.