NPIMap

Organization Active NPI

Elemental Telehealth LTD

  • Child & Adolescent Psychiatry Physician
  • Orland Park, IL
National Provider Identifier
1093473241
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
ELEMENTAL TELEHEALTH LTD
Practice address
14484 John Humphrey Dr
Orland Park, IL 60462-2638
Phone
(708) 553-0303
Fax
(708) 364-0480
NPI assigned
Dec 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Dr. Martins A Adeoye, MD
Title
MD Ceo
Phone
(708) 364-0580

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

14484 John Humphrey Dr
Orland Park, IL 60462-2638

Mailing address

14484 John Humphrey Dr
Orland Park, IL 60462-2638
Phone (708) 553-0303

Other names 1

  • ELEMENTAL TELEHEALTH LTD. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1093473241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14484 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622638",
            "telephone_number": "708-553-0303",
            "fax_number": "708-364-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14484 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622638",
            "telephone_number": "708-553-0303",
            "fax_number": "708-364-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTAL TELEHEALTH LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-06",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "ADEOYE",
        "authorized_official_first_name": "MARTINS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD CEO",
        "authorized_official_telephone_number": "708-364-0580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELEMENTAL TELEHEALTH LTD.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.