Individual provider Active NPI

Toni Elugbadebo

  • Dentist
  • Schaumburg, IL
National Provider Identifier
1447636808
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030403 Issued in IL
Practice address
2050 E Algonquin Rd Ste 610
Schaumburg, IL 60173-4166
Phone
(888) 988-4066
Fax
(847) 496-7603
NPI assigned
Aug 7, 2015
Last updated
Aug 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019030403 IL Primary

Addresses

Primary practice location

2050 E Algonquin Rd Ste 610
Schaumburg, IL 60173-4166

Mailing address

2050 E Algonquin Rd Ste 610
Schaumburg, IL 60173-4166
Phone (888) 988-4066

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026001482 IL Practitioner - Dentist 6608184619 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019030403ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center CurrentSince Jul 21, 2021 Accepting new patients
Howard Brown Health Center Current Accepting new patients
Howard Brown Health Center CurrentSince Jul 21, 2021 Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

641 W 63rd St
Chicago, IL 60621
Phone (312) 413-4070

Interoperability endpoints

  • Direct secure messaging: telugbadebo581446@direct.ochin.org

Organizations & group practices 4

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": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1447636808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELUGBADEBO",
        "first_name": "TONI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.