Individual provider Active NPI

Islam Elboghdady, M.D.

  • Orthopaedic Surgery Physician
  • Naperville, IL
National Provider Identifier
1043692585
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036.157276 Issued in IL
Practice address
120 Spalding Dr Ste 400
Naperville, IL 60540-6559
Phone
(630) 967-2225
NPI assigned
Jun 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125067483 IL
Student in an Organized Health Care Education/Training Program 390200000X 305029 NY
Orthopaedic Surgery Physician 207X00000X 036.157276 IL Primary

Addresses

Primary practice location

120 Spalding Dr Ste 400
Naperville, IL 60540-6559

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elboghdady232496@direct.edward.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210814000284 IL Practitioner - Orthopedic Surgery 9739583600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rush Medical College of Rush University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

120 Spalding Dr
Suite 100
Naperville, IL 60540-6526
Phone (630) 961-0423

Hospital & facility affiliations

  • Liberty Home Health Care, Inc Home health agency, Chicago, IL, CCN 147825
  • Newsome Home Health Care & Purpose Care of Illinois - Joliet Home health agency, Joliet, IL, CCN 148208
  • Loyal Home Health Home health agency, Hoffman Estates, IL, CCN 148150
  • Edward Hospital Hospital, Naperville, IL, CCN 140231
  • Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion134
Laminectomy or laminotomy (partial removal of spine bones)31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.157276ILMDOrthopaedic Surgery Physician
125067483ILMDOrthopaedic Surgery Physician
305029NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Sep 6, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince Sep 6, 2021 Accepting new patients
Chicago Prostate Cancer Surgery Center, LLC Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

120 Spalding Dr
Ste 100
Naperville, IL 60540
Phone (630) 790-1700

120 Spalding Dr
Ste 400
Naperville, IL 60540
Phone (630) 967-2225

815 Pasquinelli Dr
Westmont, IL 60559
Phone (630) 366-7854

Interoperability endpoints

  • Direct secure messaging: ielboghdady232496@dulyhealthandcare.direct-ci.com

Organizations & group practices 3

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 6

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": "1434844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1043692585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SPALDING DR STE 400",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406559",
            "telephone_number": "630-967-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBOGHDADY",
        "first_name": "ISLAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-21",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125067483",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "305029",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036.157276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elboghdady232496@direct.edward.org",
            "affiliation": "N",
            "address_1": "120 Spalding Dr Ste 400",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605406559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.