Organization Active NPI

Otangeles Medical of Illinois, Inc.

  • Internal Medicine Physician
  • Bloomington, IL
National Provider Identifier
1023934643
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OTANGELES MEDICAL OF ILLINOIS, INC.
Practice address
8 Derby Way
Bloomington, IL 61704-2820
Phone
(219) 256-6002
NPI assigned
Jun 26, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dionne C Okafor, MD
Title
President
Phone
(219) 256-6002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

8 Derby Way
Bloomington, IL 61704-2820

Mailing address

8 Derby Way
Bloomington, IL 61704-2820
Phone (219) 256-6002

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1023934643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 DERBY WAY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042820",
            "telephone_number": "219-256-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DERBY WAY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042820",
            "telephone_number": "219-256-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTANGELES MEDICAL OF ILLINOIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-27",
        "status": "A",
        "authorized_official_last_name": "OKAFOR",
        "authorized_official_first_name": "DIONNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-256-6002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.