NPIMap

Individual provider Active NPI

Teddy Enoh, MD

  • Acute Care Nurse Practitioner
  • Plano, IL
National Provider Identifier
1114484185
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209031044 Issued in IL
Practice address
4127 Osbron St
Plano, IL 60545-1498
Phone
(630) 340-0409
NPI assigned
Feb 26, 2019
Last updated
Jun 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209031044 IL Primary

Addresses

Primary practice location

4127 Osbron St
Plano, IL 60545-1498

Mailing address

4127 Osbron St
Plano, IL 60545-1498
Phone (630) 340-0490

Other practice location 1

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250102002380 IL Practitioner - Nurse Practitioner 7315474350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians to You Home Health LimitedGroup PAC ID 5193972164, 10 clinicians

Practice addresses (Care Compare)

6916 Cermak Rd
Berwyn, IL 60402-2244
Phone (708) 933-3840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209031044ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians to You Home Health Limited Home Health Aide CurrentSince Jan 14, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 24, 2025 Accepting new patients
City Home Health Services LLC Current Accepting new patients
Skyline Healthcare CurrentSince Dec 23, 2024 Accepting new patients
Cardinal Medical Group, LTD. PastSince Apr 24, 2025 Accepting new patients

Locations

6916 Cermak Rd
Berwyn, IL 60402
Phone (708) 933-3840

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

2500 W Reynolds St
Ste 101
Pontiac, IL 61764
Phone (815) 844-4062

Interoperability endpoints

  • Direct secure messaging: teddy.enoh.1@28492.direct.athenahealth.com

Organizations & group practices 6

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

Hospital & facility affiliations 5

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": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1114484185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4127 OSBRON ST",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605451498",
            "telephone_number": "630-340-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4127 OSBRON ST",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605451498",
            "telephone_number": "630-340-0409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W Reynolds St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "IL",
            "postal_code": "617649774",
            "country_code": "US",
            "telephone_number": "815-842-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENOH",
        "first_name": "TEDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209031044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, IL

Sources for this page

Verify at the official NPI Registry.