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Organization

ELITE MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRAIG MATHIESON (PARTNER)
(309) 663-4443
Entity
Organization

Contact information

Practice address
3002 GILL ST, BLOOMINGTON, IL 61704-3438
(309) 663-4443
Mailing address
PO BOX 710, BLOOMINGTON, IL 61702-0710
(309) 663-4443

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
IL

Other

Enumeration date
04/24/2007
Last updated
08/22/2020
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