Individual provider Active NPI

Elisa Anne Illing, M.D.

  • Otolaryngology Physician
  • Indianapolis, IN
National Provider Identifier
1851619845
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01077276A Issued in IN
Practice address
1130 W Michigan St Ste 400
Indianapolis, IN 46202-5209
Phone
(317) 278-1219
NPI assigned
May 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 01077276A IN Primary

Addresses

Primary practice location

1130 W Michigan St Ste 400
Indianapolis, IN 46202-5209

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address eilling35100@direct.eskenazihealth.edu Direct
Direct Messaging Address EILLING@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160915000082 IN Practitioner - Otolaryngology 8921244609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngology Associates, Inc. Otolaryngology CurrentSince Aug 13, 2016 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7631 Solutions Ctr
Chicago, IL 60677

1111 Ronald Reagan Pkwy
Rm 12028
Avon, IN 46123
Phone (317) 217-3257

1115 Ronald Reagan Pkwy
Ste 254
Avon, IN 46123
Phone (317) 705-2700

1801 Senate Blvd
Indianapolis, IN 46202
Phone (317) 929-8880

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

355 W 16th St
Ste 3000
Indianapolis, IN 46202
Phone (317) 963-7082

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

575 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 944-3966

1130 W Michigan St
Ste 400
Indianapolis, IN 46202
Phone (317) 278-1219

Interoperability endpoints

  • Direct secure messaging: eilling35100@direct.eskenazihealth.edu
  • Direct secure messaging: eilling@direct.iuhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1851619845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 W MICHIGAN ST STE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "317-278-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLING",
        "first_name": "ELISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01077276A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eilling35100@direct.eskenazihealth.edu",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email address",
            "address_1": "1130 W Michigan St Ste 400",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EILLING@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1130 W Michigan St Ste 400",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.