Open Door Clinic of Greater Elgin

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

OPEN DOOR CLINIC OF GREATER ELGIN

Practice address

1665 Larkin Ave
Elgin, IL 60123-5977

Phone

(847) 695-1093

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Anna Avila

Title

Office Manager

Phone

(331) 588-1971

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Open Door Clinic

  • Infectious Disease Physician
  • Aurora, IL
  • NPI 1174902555

  O20050914000576

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Open Door Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Open Door Clinic

  • Infectious Disease Physician
  • Aurora, IL
  • NPI 1245516939
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Josh Lopez

  • Family Nurse Practitioner
  • Elgin, IL
  • NPI 1184166001
  Medicare reassignment Care Compare group NPD
• Thomas Jorge Torrez

  • Family Nurse Practitioner
  • Elgin, IL
  • NPI 1902622079

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Vivian Adeck Ndangoh-Tendong, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Aurora, IL
  • NPI 1962075473
  Medicare reassignment NPD
• Anjolie Elizabeth Jose, PA-C

  • Physician Assistant
  • Aurora, IL
  • NPI 1437863792
  Medicare reassignment
• Anita Emma Appoh, ANP-BC

  • Family Nurse Practitioner
  • Montgomery, IL
  • NPI 1326789223
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1255354635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 LARKIN AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235977",
            "telephone_number": "847-695-1093",
            "fax_number": "847-695-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 LARKIN AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235977",
            "telephone_number": "847-695-1093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 S Lincoln Ave Ste K",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605054291",
            "country_code": "US",
            "telephone_number": "847-695-1093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPEN DOOR CLINIC OF GREATER ELGIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "331-588-1971"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kunume Onwueme, LCSW
• J. Nnaemeka Onwuta, M.D.
• Nneka Onwuta
• Mini Joy Oommen
• Lauren Marie Opatrny, DPT
• Open Doors of Kane County
• Ophthalmology Associates LTD
• Matas Orentas, DO
• Lorena M Orizaba
• Yajaira Ortega

• Medical Specialty Clinic/Center in Elgin, IL
• Providers in Elgin, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.