ELITE IOM LLC NPI 1952196586

NPI Information

  • NPI: 1952196586
  • Provider Name: ELITE IOM LLC
  • Classification: Psychiatry & Neurology - 2084N0600X
  • Specialization: Clinical Neurophysiology
  • Entity Type: Organization
  • Address: 2501 CHATHAM RD STE R
    SPRINGFIELD, IL
    ZIP 62704
  • Phone: (866) 374-6628

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NPI Details

ELITE IOM LLC is a clinical neurophysiology psychiatry neurology in Springfield, IL. The provider is clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). ELITE IOM LLC NPI is 1952196586. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2501 CHATHAM RD STE R
SPRINGFIELD, IL
ZIP 62704-188
Phone: (866) 374-6628
Fax: (866) 951-1120

The provider's authorized official is Jenna Bledsoe .
The authorized official title is Cheif Operating Officer and has the following contact phone number (866) 374-6628.

The enumeration date for this NPI number is 4/14/2025 and was last updated on 4/14/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0600XPsychiatry & NeurologyClinical NeurophysiologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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