Active NPI
Ellaine Quiminiano
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1871389783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 125.086990
- Practice address
- 1127 N Oakley Blvd FL 2
Chicago, IL 60622-3507 - Phone
- (312) 770-2040
- Fax
- (312) 770-3270
- NPI assigned
- Apr 17, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 125.086990 | IL | Primary |
Addresses
Primary practice location
1127 N Oakley Blvd FL 2
Chicago, IL 60622-3507
Mailing address
1127 N Oakley Blvd FL 2
Chicago, IL 60622-3507
Phone (312) 770-2040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.086990 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753315200000",
"number": "1871389783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1127 N OAKLEY BLVD FL 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606223507",
"telephone_number": "312-770-2040",
"fax_number": "312-770-3270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 N OAKLEY BLVD FL 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606223507",
"telephone_number": "312-770-2040",
"fax_number": "312-770-3270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIMINIANO",
"first_name": "ELLAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-17",
"last_updated": "2025-07-24",
"certification_date": "2025-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125.086990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.