Active NPI
Mary Udoh
- Homemaker
- Chicago, IL
National Provider Identifier
1073068995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 3001321
- Practice address
- 4554 N Broadway St
Suite #333
Chicago, IL 60640-5642 - Phone
- (312) 208-7304
- NPI assigned
- Aug 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | 3001321 | IL | Primary |
Addresses
Primary practice location
4554 N Broadway St
Suite #333
Chicago, IL 60640-5642
Mailing address
4554 N Broadway St
Suite #333
Chicago, IL 60640-5642
Phone (312) 208-7304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3001321 | IL | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471737600000",
"number": "1073068995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4554 N BROADWAY ST",
"address_2": "SUITE #333",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405642",
"telephone_number": "312-208-7304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4554 N BROADWAY ST",
"address_2": "SUITE #333",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405642",
"telephone_number": "312-208-7304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDOH",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-21",
"last_updated": "2016-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "IL",
"license": "3001321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.