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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WILLIE JAMES ELLIOTT JR. MD, MSC
NPI 1194529297
Student in an Organized Health Care Education/Training Program in Maywood, IL

Active since April 01, 2025PECOS Enrolled
2160 S 1ST AVE, MAYWOOD, IL 60153(708) 216-6001 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Willie James Elliott Jr. Md, Msc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIE JAMES ELLIOTT JR. MD, MSC (NPI 1194529297) is an individual student in an organized health care education/training program in Maywood, Illinois, licensed in Illinois (125088592) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194529297
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameWILLIE JAMES ELLIOTT JR.Credential: MD, MSC
Location Address2160 S 1ST AVEMaywood, IL 60153-3328
Mailing Address2160 S 1st AveMaywood, IL 60153-3328 · (708) 216-6001
Phone(708) 216-6001
Sole ProprietorYes
Enumeration DateApril 1, 2025
Last NPPES UpdateJune 30, 2026
NPPES CertifiedJune 30, 2026
✔ NPI 1194529297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in IL · 125088592
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 125.088592 (IL)
2160 S 1ST AVE, Maywood, IL 60153
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Willie James Elliott Jr. Md, Msc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANITA OZA NAGAMINE M.D.
Radiology (Diagnostic Radiology)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
DR. BRYCE ANDREW PASCHOLD D.P.M.
Podiatrist (Foot & Ankle Surgery)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-4254
DR. ANTONIO HERNANDO IGLESIAS M.D.
Psychiatry & Neurology (Neurology)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
IAN CHARLES MCCOMB
Oral & Maxillofacial Surgery
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
JAMES WU D.O.
Psychiatry & Neurology (Psychiatry)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
PAIGE T SONG MD
Student in an Organized Health Care Education/Training Program
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (888) 584-7888
ELIZABETH CHO
Orthopaedic Surgery
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-1274
DR. CATHRYN T SAWALSKI DO, MBA
Internal Medicine
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (888) 584-7888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willie Elliott's NPI number?

The NPI number for Willie Elliott is 1194529297. It was assigned to this individual provider in the NPPES registry on April 1, 2025.

Where is Willie Elliott located?

Willie Elliott practices at 2160 S 1st Ave, Maywood, IL 60153. The listed phone number is (708) 216-6001.

What is Willie Elliott's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Willie Elliott enrolled in Medicare?

Yes. Willie Elliott is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Willie Elliott was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.