Elwan Medical Associates

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036144602 Issued in IL

Legal business name

ELWAN MEDICAL ASSOCIATES

Practice address

200 Lori CT
Medinah, IL 60157-9733

Phone

(815) 519-9261

NPI assigned

May 9, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Basil Ali, MD

Title

Ceo

Phone

(630) 808-5945

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1801385430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LORI CT",
            "city": "MEDINAH",
            "state": "IL",
            "postal_code": "601579733",
            "telephone_number": "815-519-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LORI CT",
            "city": "MEDINAH",
            "state": "IL",
            "postal_code": "601579733",
            "telephone_number": "815-519-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELWAN MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "BASIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-808-5945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036144602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Medinah, IL
• Providers in Medinah, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.