Individual provider Active NPI

Siva Kumar Elangovan, M.D.

  • Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1467773960
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036.136046 Issued in IL
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

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150604000933 IL Practitioner - Otolaryngology 3577702877

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-8953IAMDOtolaryngology Physician
036.136046ILMDOtolaryngology Physician

Interoperability endpoints

  • FHIR API: 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

Verify at the official NPI Registry.