Elba Maritza Villavicencio, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036131538 Issued in IL

Practice address

7000 Cermak Rd
Berwyn, IL 60402-2112

Phone

(708) 484-8090

NPI assigned

Jan 9, 2010

Last updated

Jun 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evillavicencio236785@direct.northshore.org

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Allergy & Immunology Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment NPD
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643
  Medicare reassignment NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

{
    "created_epoch": "1262995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1720318074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022112",
            "telephone_number": "708-484-8090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 Rollins Rd",
            "address_2": "Suite1100",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600311512",
            "country_code": "US",
            "telephone_number": "847-356-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "ELBA",
        "middle_name": "MARITZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-09",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036131538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evillavicencio236785@direct.northshore.org",
            "affiliation": "N",
            "address_1": "7900 Rollins Rd",
            "address_2": "Suite1100",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600311512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• VHS of Illinois Inc (MacNeal Hospital Center for Cancer Care)
• VHS of Illinois Inc (Berwyn Magnetic Resonance Center)
• Jose Alberto Villarreal Castellanos, MD
• Villasenor in-Home Patient Care LLC
• Martha C. Villasenor, D.D.S.
• Olga S Vinokur, M.D.
• Visionworks Inc (Visionworks)
• Margaret Anne Vizgirda, D.D.S.
• Samantha Volk
• Slobodan D Vucicevic, M.D.

• Family Medicine Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.

Verify at the official NPI Registry.