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1396237095
ELIAS TRACE
SPRINGFIELD, IL
NPI
1396237095
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: IL 125072391)
Enumeration Date
2018-05-30
Last Update Date
2021-04-15
Business Address
ELIAS TRACE MD
701 N 1ST ST STE D220
SPRINGFIELD, IL 62702-3757
Phone number: 217-545-3518
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Mailing Address
ELIAS TRACE MD
PO BOX 19679
SPRINGFIELD, IL 62794-9679
Phone number: 217-545-3518
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