Individual
ASIM ELMAHBOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-1230
Mailing address
900 JORIE BLVD, SUITE 186, OAK BROOK, IL 60523-2213
(630) 954-6700
(630) 954-1555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.092411
IL
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
036-092411
IL
208M00000X
Hospitalist Physician
036.092411
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036092477
—
IL
01
—
L51016
MEDICARE PIN FOR GOUP #645650
IL
Enumeration date
06/01/2006
Last updated
05/10/2019
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