Individual provider Active NPI

Elena Valery Trukhacheva, M.D.

  • Specialist
  • Oak Brook, IL
National Provider Identifier
1821227588
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036.116050 Issued in IL
Practice address
2425 W 22ND St
Suite 102
Oak Brook, IL 60523-1245
Phone
(630) 954-0054
Fax
(630) 954-0064
NPI assigned
Jul 2, 2009
Last updated
Jul 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036.116050 IL Primary

Addresses

Primary practice location

2425 W 22ND St
Suite 102
Oak Brook, IL 60523-1245

Mailing address

2425 W 22ND St
Suite 102
Oak Brook, IL 60523-1245
Phone (630) 954-0054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 15, 2019 through Jan 15, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.116050ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
W.P. Dmowski, M.D.. PH.D. & Associates S.C. Specialist Past Accepting new patients

Organizations & group practices 1

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1821227588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST",
            "address_2": "SUITE 102",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231245",
            "telephone_number": "630-954-0054",
            "fax_number": "630-954-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST",
            "address_2": "SUITE 102",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231245",
            "telephone_number": "630-954-0054",
            "fax_number": "630-954-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUKHACHEVA",
        "first_name": "ELENA",
        "middle_name": "VALERY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036.116050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.