Elida Gricelda Trejo, FNP-BC is a medicare enrolled "Family Medicine" physician in Beach Park, Illinois. Her current practice location is
11316 W Wadsworth Rd Ste 103, Beach Park, Illinois. You can reach out to her office (for appointments etc.) via phone at
(708) 404-9070.
Elida Gricelda Trejo is licensed to practice in Illinois (license number 277004895) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811777683.
Physician's Profile
| Full Name | Elida Gricelda Trejo |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 11316 W Wadsworth Rd Ste 103, Beach Park, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811777683
- Provider Enumeration Date: 09/29/2023
- Last Update Date: 04/06/2026
Medicare PECOS Information:
- PECOS PAC ID: 3779935010
- Enrollment ID: I20240123000396
Medical Identifiers
Medical identifiers for Elida Gricelda Trejo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811777683 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 277004895 (Illinois) | Primary |
| 163WA0400X | Registered Nurse - Addiction (substance Use Disorder) | 041494182 (Illinois) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Elida Gricelda Trejo allows following entities to bill medicare on her behalf.
| Entity Name | Provida Health Center Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881890333
PECOS PAC ID: 1557386273
Enrollment ID: O20051012000360 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elida Gricelda Trejo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Elida Gricelda Trejo, FNP-BC
1425 N Hunt Club Rd Ste 100,
Gurnee, IL 60031-2632
Ph: (847) 548-2200 | Elida Gricelda Trejo, FNP-BC
11316 W Wadsworth Rd Ste 103,
Beach Park, IL 60099-3367
Ph: (708) 404-9070 |
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