Organization Active NPI

Elena Fitchev MD LTD

  • Family Medicine Physician
  • Evanston, IL
National Provider Identifier
1912122383
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036092221 Issued in IL
Legal business name
ELENA FITCHEV MD LTD
Practice address
800 Austin St Ste 502W
Evanston, IL 60202-3445
Phone
(847) 328-3213
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Authorized official

Name
Elena Fitchev, MD
Title
Owner
Phone
(847) 328-3213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036092221 IL Primary

Addresses

Primary practice location

800 Austin St Ste 502W
Evanston, IL 60202-3445

Mailing address

800 Austin St Ste 502W
Evanston, IL 60202-3445
Phone (847) 328-3213

Other identifiers 1

IdentifierTypeStateIssuer
036092221MedicaidIL

National Provider Directory

National Provider Directory

Locations

800 Austin St
Ste 502W
Evanston, IL 60202
Phone (847) 328-3213

800 Austin St
Ste 502
Evanston, IL 60202
Phone (847) 328-3213

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1912122383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST STE 502W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023445",
            "telephone_number": "847-328-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST STE 502W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023445",
            "telephone_number": "847-328-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELENA FITCHEV MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "FITCHEV",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-328-3213",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036092221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092221",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.