Individual
DR. IBRAHIM AMAE ELEMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-5811
(217) 464-1318
Mailing address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-5811
(217) 464-1318
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036134398
IL
208M00000X
Hospitalist Physician
036134398
IL
208M00000X
Hospitalist Physician
61530
MN
Other
Enumeration date
08/10/2011
Last updated
03/12/2021
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