ELLIANA BRODY – Psychiatric/Mental Health Nurse Practitioner, NPI 1588458590

ELLIANA BRODY is a healthcare provider. based in Northbrook, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 041.529434 (IL). The NPI Number for ELLIANA BRODY is 1588458590

Main info

Organization
Sole Proprietor
1 Year Of Experience
Name
ELLIANA BRODY
NPI
1588458590
Phone
Not provided
Address
3100 DUNDEE RD STE 101
Enumeration Date
7 April 2025
Last Update Date
3 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8479199096
Graduation Year
2025 (1 year ago)
PAC ID
9234621657
Group Practice PAC ID
6800252669
Professional Enrollment ID
I20251124001316
Address ID
IL600622462NO3100XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:1State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for ELLIANA BRODY

  • 3100 DUNDEE RD STE 101

    NORTHBROOK, IL 600622462

    Phone:

    Fax: (224) 216-2360

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251124001316INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60062)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800252669View full group profile
NameSpecialtyState
Nurse PractitionerIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL
Nurse PractitionerIL
Mental Health CounselorIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

How is ELLIANA BRODY identified in CMS data?
CMS-hosted NPPES data lists ELLIANA BRODY with NPI 1588458590.
Does the file indicate ELLIANA BRODY is practicing under active NPI?
Directory data currently reports ELLIANA BRODY as active.
What taxonomy line describes ELLIANA BRODY?
For research purposes, treat ELLIANA BRODY as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Does ELLIANA BRODY list a practice location?
Patients near Northbrook, Illinois may find ELLIANA BRODY in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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