Elite Iom LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

ELITE IOM LLC

Practice address

2501 Chatham Rd Ste R
Springfield, IL 62704-4188

Phone

(866) 374-6628

Fax

(866) 951-1120

NPI assigned

Apr 14, 2025

Organization subpart

No

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

Authorized official

Name

Kelly McClintock, CPCO

Title

Compliance Officer

Phone

(866) 374-6628

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1952196586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE R",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "866-374-6628",
            "fax_number": "866-951-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE R",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "866-374-6628",
            "fax_number": "866-951-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE IOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "MCCLINTOCK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "866-374-6628",
        "authorized_official_credential": "CPCO"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aya El Jerbi, MD
• Ahmad El Kouzi, M.D
• Wendi Wills El-Amin, M.D.
• Rodger J Elble, M.D.
• Evelyn Kerrick Eldridge, PTA
• Mahmoud Elkhooly
• Jamarria Ell
• Kylee Marie Elleman, DO
• Jeremy Elliott
• Sandra K. Elliott, FNP-BC

• Clinical Neurophysiology Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Neurophysiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.

Verify at the official NPI Registry.