Organization
ELMHURST MEMORIAL HEALTHCARE
Active
Other names
Elmhurst Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD R LURYE MD (CEO)
(630) 993-5676
Entity
Organization
Contact information
Practice address
1100 LAKE ST, OAK PARK, IL 60301
(708) 524-1420
Mailing address
172 E SCHILLER ST, ELMHURST, IL 60126-2816
(630) 834-1120
(630) 993-5681
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2215149
BCBS OF IL
IL
Enumeration date
08/13/2007
Last updated
12/11/2009
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