Active NPI
Elaine Felicia Burke, D.O.
- Psychiatry Physician
- Chicago, IL
National Provider Identifier
1114238680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036.144845
- Practice address
- 4740 N Clark St
Chicago, IL 60640-4689 - Phone
- (773) 769-0205
- NPI assigned
- Jun 29, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 51827 | CT | |
| Psychiatry Physician | 2084P0800X | 68608-21 | WI | |
| Psychiatry Physician | 2084P0800X | 036.144845 | IL | Primary |
Addresses
Primary practice location
4740 N Clark St
Chicago, IL 60640-4689
Mailing address
PO Box 527
Milford, CT 06460-0527
Phone (312) 878-4521
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-144845 | Other | IL | ILLINOIS STATE LICENSE |
| 68608-21 | Other | WI | WISCONSIN STATE LICENSE |
Other names 1
- Elaine Felicia Gould
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51827 | CT | MD | Psychiatry Physician |
| 036.144845 | IL | MD | Psychiatry Physician |
| 68608-21 | WI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523232000000",
"number": "1114238680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 527",
"city": "MILFORD",
"state": "CT",
"postal_code": "064600527",
"telephone_number": "312-878-4521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4740 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404689",
"telephone_number": "773-769-0205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "ELAINE",
"middle_name": "FELICIA",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-29",
"last_updated": "2018-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "51827",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "68608-21",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036.144845",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS STATE LICENSE",
"identifier": "036-144845",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN STATE LICENSE",
"identifier": "68608-21",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELAINE",
"last_name": "GOULD",
"middle_name": "FELICIA",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.