Individual
DR. ELTON XAVIER TINSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
845 N MICHIGAN AVE, SUITE 957W, CHICAGO, IL 60611-2252
(312) 222-0030
(312) 649-5808
Mailing address
PO BOX 804193, CHICAGO, IL 60680-4103
(312) 222-0030
(312) 649-5808
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36079325
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01607698
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/02/2007
Last updated
07/08/2007
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