Active NPI
Siva Kumar Elangovan, M.D.
- Otolaryngology Physician
- Chicago, IL
National Provider Identifier
1467773960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036.136046
- Practice address
- 680 N Lake Shore Dr Ste 1425
Chicago, IL 60611-4451 - Phone
- (312) 480-1387
- NPI assigned
- Jun 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | R-8953 | IA | |
| Otolaryngology Physician | 207Y00000X | 036.136046 | IL | Primary |
Addresses
Primary practice location
680 N Lake Shore Dr Ste 1425
Chicago, IL 60611-4451
Mailing address
545 Valley View Drive
Moline, IL 61265
Phone (309) 762-5560
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150604000933 | IL | Practitioner - Otolaryngology | 3577702877 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-8953 | IA | MD | Otolaryngology Physician |
| 036.136046 | IL | MD | Otolaryngology Physician |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FCIHDD/Endpoint/FCIHDD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1467773960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 VALLEY VIEW DRIVE",
"city": "MOLINE",
"state": "IL",
"postal_code": "61265",
"telephone_number": "309-762-5560",
"fax_number": "309-277-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 N LAKE SHORE DR STE 1425",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114451",
"telephone_number": "312-480-1387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELANGOVAN",
"first_name": "SIVA",
"middle_name": "KUMAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-18",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IA",
"license": "R-8953",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036.136046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.