Organization
ELITE IOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MCCLINTOCK CPCO (COMPLIANCE OFFICER)
(866) 374-6628
Entity
Organization
Contact information
Practice address
2501 CHATHAM RD STE R, SPRINGFIELD, IL 62704-4188
(866) 374-6628
(866) 951-1120
Mailing address
2501 CHATHAM RD STE R, SPRINGFIELD, IL 62704-4188
(866) 374-6628
(866) 951-1120
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
12/29/2025
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