Individual provider Active NPI

Elan M Volchenko, MD

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1295360105
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
125.078623 Issued in IL
Practice address
830 W Diversey Pkwy RM 300
Chicago, IL 60614-1454
Phone
(773) 248-4150
NPI assigned
Mar 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125.078623 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

830 W Diversey Pkwy RM 300
Chicago, IL 60614-1454

Mailing address

1853 W Polk St
Chicago, IL 60612-4355

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
I20210706000175 IL Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 7315349917

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.078623ILMDOrthopaedic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: emelman87095@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1295360105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1853 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 W DIVERSEY PKWY RM 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141454",
            "telephone_number": "773-248-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLCHENKO",
        "first_name": "ELAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125.078623",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.