Individual provider Active NPI

Luan Elezi, M.D.

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1659635092
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-136456 Issued in IL
Practice address
32 E 1St St Ste 203
Hinsdale, IL 60521-4288
Phone
(630) 724-1680
Fax
(630) 724-8735
NPI assigned
Jun 29, 2012
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125062270 IL
Family Medicine Physician 207Q00000X 64214-20 WI
Family Medicine Physician 207Q00000X 036-136456 IL Primary

Addresses

Primary practice location

32 E 1St St Ste 203
Hinsdale, IL 60521-4288

Mailing address

32 E 1St St Ste 203
Hinsdale, IL 60521-4288
Phone (630) 724-1680

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
I20150708002497 IL Practitioner - Family Practice 5597077222 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-136456ILMDFamily Medicine Physician
125062270ILMDFamily Medicine Physician
64214-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jan 10, 2022 Accepting new patients
Beloit Health System Inc Family Medicine CurrentSince Sep 1, 2015 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

7702 N Alpine Rd
Loves Park, IL 61111
Phone (815) 971-3397

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

Organizations & group practices 2

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1659635092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 E 1ST ST STE 203",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605214288",
            "telephone_number": "630-724-1680",
            "fax_number": "630-724-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E 1ST ST STE 203",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605214288",
            "telephone_number": "630-724-1680",
            "fax_number": "630-724-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEZI",
        "first_name": "LUAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125062270",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "64214-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-136456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.