Individual provider Active NPI

Elise Marie Charron, DO

  • Emergency Medicine Physician
  • Pingree Grove, IL
National Provider Identifier
1295439461
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036179098 Issued in IL
Practice address
2444 Aurora Dr
Pingree Grove, IL 60140-6402
Phone
(847) 722-2696
NPI assigned
Mar 29, 2023
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036179098 IL Primary

Addresses

Primary practice location

2444 Aurora Dr
Pingree Grove, IL 60140-6402

Mailing address

808 S Wood St RM 471
Chicago, IL 60612-7300
Phone (312) 355-8002

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
I20260624001247 IL Practitioner - Emergency Medicine 7214400068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

124 SW Adams St
Peoria, IL 61602-1308

2800 W 95TH St
Evergreen, IL 60805-2701

5665 New Northside Dr
320 Suite 320
Sandy Springs, GA 30328-5834

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036179098ILMDEmergency Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1295439461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S WOOD ST RM 471",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127300",
            "telephone_number": "312-355-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 AURORA DR",
            "city": "PINGREE GROVE",
            "state": "IL",
            "postal_code": "601406402",
            "telephone_number": "847-722-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARRON",
        "first_name": "ELISE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036179098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pingree Grove, IL

Sources for this page

Verify at the official NPI Registry.