Organization
DR ELTON X TINSLEY & ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELTON XAVIER TINSLEY M.D. (PRESIDENT)
(312) 222-0030
Entity
Organization
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
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
36079325
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01607698
BLUE CROSS BLUE SHIELD
IL
05
—
036079325
—
IL
Enumeration date
05/02/2007
Last updated
01/07/2009
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