Ali El Ghazzaoui, MD

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

036163784 Issued in IL

Practice address

420 NE Glen Oak Ave
Peoria, IL 61603-3106

Phone

(647) 404-7544

NPI assigned

May 1, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1881383404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9581 WESTWOOD DR",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836949",
            "telephone_number": "647-404-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033106",
            "telephone_number": "647-404-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL GHAZZAOUI",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "IL",
            "license": "036163784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert R. Ehrich, D.D.S.
• Bazal Ehsan
• Kathleen Rose Eichinger, M.D.
• Sarah Katherine Eigsti, SLP
• Jamie Eilts, PT
• Fahed Nazem Elchami, DPM
• Isaac Elkins, DO
• Katherine Ellingson, AG-ACNP-BC
• Linda Marie Elliott, PTA
• Catherine A Ellis, LCSW

• Pediatric Urology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Pediatric Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.