Elizabeth Wilma Canelas, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-084800 Issued in IL

Practice address

6238 Cermak Rd
Berwyn, IL 60402-2319

Phone

(708) 795-5020

Fax

(708) 795-5023

NPI assigned

Apr 20, 2007

Last updated

Apr 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Prosalud6238 Inc

  • Pediatrics Physician
  • Berwyn, IL
  • NPI 1013452168
  Authorized official Same address or phone
• The Thresholds

  dba Bridge Southwest DuPage CST

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westmont, IL
  • NPI 1083590996
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1376761080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6238 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022319",
            "telephone_number": "708-795-5020",
            "fax_number": "708-795-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6238 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022319",
            "telephone_number": "708-795-5020",
            "fax_number": "708-795-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANELAS",
        "first_name": "ELIZABETH",
        "middle_name": "WILMA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-084800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabeth.canelas@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Busker, M.A.
• Esteban Andres Cabezas Rubio, MD
• Micah Jr Caldwell, MS, LPCC, LCPC
• Camilleri Medical Center LTD
• Mark Camilleri, DPM
• Beatriz Noemi Cano, LCPC
• Claudelia Cano, FNP
• Caitlin Canton
• Rhodessa Capulong, M.D.
• Ariana Cardenas

• Psychiatry Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.