Healthcare Provider Details

I. General information

NPI: 1689537318
Provider Name (Legal Business Name): MRS. ELENA LEAH SIMKHOVICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16801 CHILLICOTHE RD
CHAGRIN FALLS OH
44023-4618
US

IV. Provider business mailing address

16801 CHILLICOTHE RD
CHAGRIN FALLS OH
44023-4618
US

V. Phone/Fax

Practice location:
  • Phone: 440-543-7475
  • Fax: 440-708-2341
Mailing address:
  • Phone: 440-543-7475
  • Fax: 440-708-2341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0040951
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: