Organization Active NPI

Dr Elborno Center Inc

  • Pain Medicine (Anesthesiology) Physician
  • Willowbrook, IL
National Provider Identifier
1619354081
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
DR ELBORNO CENTER INC
Practice address
6747 Kingery Hwy
Willowbrook, IL 60527-5142
Phone
(630) 952-1412
NPI assigned
May 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Authorized official

Name
Dr. Ahmed Elborno, M.D.NPI 1750388476
Title
President
Phone
(630) 952-1412

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

6747 Kingery Hwy
Willowbrook, IL 60527-5142

Mailing address

6747 Kingery Hwy
Willowbrook, IL 60527-5142
Phone (630) 952-1412

Other practice location 1

6823 Kingery Hwy
Willowbrook, IL 60527-5154
Phone (630) 952-1412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151007000888 IL Part B Supplier - Clinic/Group Practice 3870801186 Receives reassigned benefits from 1 practitioner
Practice locations: Willowbrook, IL

National Provider Directory

National Provider Directory

Locations

6747 Kingery Hwy
Willowbrook, IL 60527
Phone (630) 455-5844

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1619354081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6747 KINGERY HWY",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275142",
            "telephone_number": "630-952-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6747 KINGERY HWY",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275142",
            "telephone_number": "630-952-1412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6823 Kingery Hwy",
            "address_purpose": "LOCATION",
            "city": "Willowbrook",
            "state": "IL",
            "postal_code": "605275154",
            "country_code": "US",
            "telephone_number": "630-952-1412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR ELBORNO CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "ELBORNO",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-952-1412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.