Healthcare Provider Details

I. General information

NPI: 1538665286
Provider Name (Legal Business Name): ELHAM AZIZI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 PFINGSTEN RD STE 2000
GLENVIEW IL
60026-1339
US

IV. Provider business mailing address

2180 PFINGSTEN RD STE 2000
GLENVIEW IL
60026-1339
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2000
  • Fax: 847-570-2073
Mailing address:
  • Phone: 847-570-2000
  • Fax: 847-570-2073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036.158611
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number0361586117
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: