Healthcare Provider Details

I. General information

NPI: 1417698796
Provider Name (Legal Business Name): OSAMA ELKELANY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2022
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9608 S ROBERTS RD
HICKORY HILLS IL
60457-2238
US

IV. Provider business mailing address

9608 S ROBERTS RD
HICKORY HILLS IL
60457-2238
US

V. Phone/Fax

Practice location:
  • Phone: 708-233-5333
  • Fax: 708-233-5348
Mailing address:
  • Phone: 708-233-5333
  • Fax: 708-233-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036172786
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: