Individual provider Active NPI

Fahed Nazem Elchami, DPM

  • Foot & Ankle Surgery Podiatrist
  • Peoria, IL
National Provider Identifier
1013300839
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016005723 Issued in IL
Practice address
6000 N Allen Rd
Peoria, IL 61614-3294
Phone
(309) 691-1400
Fax
(309) 689-7094
NPI assigned
Mar 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016005723 IL
Foot & Ankle Surgery Podiatrist 213ES0103X 65 P88839 NY
Foot & Ankle Surgery Podiatrist 213ES0103X 016005723 IL Primary

Addresses

Primary practice location

6000 N Allen Rd
Peoria, IL 61614-3294

Mailing address

6000 N Allen Rd
Peoria, IL 61614-3294
Phone (309) 691-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160708000533 IL Practitioner - Podiatry 9436441623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Orthopaedic Center S CGroup PAC ID 8022917715, 45 clinicians

Practice addresses (Care Compare)

6000 N Allen Rd
Peoria, IL 61614-3294
Phone (309) 691-1400

Hospital & facility affiliations

  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue139
Removal of skin lesions1-10
Removal of nail tissue276
Removal or shaving of skin growth41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65 P88839NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopaedic Center S C CurrentSince Jan 1, 2017 Accepting new patients

Locations

2351 Broadway St
Pekin, IL 61554
Phone (309) 353-4159

6000 N Allen Rd
Peoria, IL 61614
Phone (309) 391-1400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1013300839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 N ALLEN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143294",
            "telephone_number": "309-691-1400",
            "fax_number": "309-689-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N ALLEN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143294",
            "telephone_number": "309-691-1400",
            "fax_number": "309-689-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELCHAMI",
        "first_name": "FAHED",
        "middle_name": "NAZEM",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-18",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005723",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "65 P88839",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.