Organization Active NPI

Seema Elahi, M.D., Inc.

  • Internal Medicine Physician
  • Lombard, IL
National Provider Identifier
1912379942
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036084250 Issued in IL
Legal business name
SEEMA ELAHI, M.D., INC.
Practice address
450 E 22ND St Ste 100
Lombard, IL 60148-6175
Phone
(630) 673-5757
Fax
(908) 605-4974
NPI assigned
Oct 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Ms. Maria D Lysandrou
Title
Administrator
Phone
(773) 588-7733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036084250 IL Primary

Addresses

Primary practice location

450 E 22ND St Ste 100
Lombard, IL 60148-6175

Mailing address

450 E 22ND St Ste 100
Lombard, IL 60148-6175
Phone (773) 588-7733

Other identifiers 1

IdentifierTypeStateIssuer
036084250MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151119000036 IL Part B Supplier - Clinic/Group Practice 0345540621 Receives reassigned benefits from 3 practitioners
Practice locations: Lombard, IL

National Provider Directory

National Provider Directory

Locations

7905 Lockwood Ave
Burbank, IL 60459
Phone (708) 636-4022

450 E 22nd St
Ste 100
Lombard, IL 60148
Phone (630) 673-5757

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1912379942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E 22ND ST STE 100",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486175",
            "telephone_number": "773-588-7733",
            "fax_number": "773-588-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E 22ND ST STE 100",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486175",
            "telephone_number": "630-673-5757",
            "fax_number": "908-605-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEEMA ELAHI, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "LYSANDROU",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-588-7733",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036084250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084250",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.