Organization
ELEMENTAL MEDICAL CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTINS A ADEOYE MD (CEO)
(331) 330-9955
Entity
Organization
Contact information
Practice address
612 S WESTERN AVE APT 1, CHICAGO, IL 60612-4682
(331) 330-9955
(708) 892-2909
Mailing address
15010 S RAVINIA AVE STE 15, ORLAND PARK, IL 60462-5353
(331) 330-9955
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036103889
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103889
—
IL
Enumeration date
11/13/2017
Last updated
10/22/2024
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