Individual provider Active NPI

Imaobong Patrick Udonkang, NP

  • Family Nurse Practitioner
  • Homewood, IL
National Provider Identifier
1093431173
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.026142 Issued in IL
Practice address
18408 Governors Hwy
Homewood, IL 60430-2911
Phone
(708) 647-0571
Fax
(708) 647-0676
NPI assigned
Oct 19, 2022
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.026142 IL Primary

Addresses

Primary practice location

18408 Governors Hwy
Homewood, IL 60430-2911

Mailing address

35318 Eagle Way
Chicago, IL 60678-1353
Phone (317) 528-4800

Other practice location 1

3315 W 115th St Unit C
Merrionette Park, IL 60803-4556
Phone (708) 907-4355

Other practice location 2

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122002143 IL Practitioner - Nurse Practitioner 7012385065 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

101 E Via Ghiglieri
Toluca, IL 61369-9596
Phone (877) 883-9430

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.026142ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Illinois, LLC CurrentSince Nov 3, 2024 Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 1, 2022 Accepting new patients
Apex Hospice and Palliative Care, Inc. CurrentSince May 9, 2024 Accepting new patients
Altea Medical Illinois PLLC CurrentSince Mar 17, 2026 Accepting new patients
Post Acute Medical PLLC CurrentSince Mar 17, 2026 Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Nov 3, 2024 Accepting new patients

Locations

35318 Eagle Way
Chicago, IL 60678

490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

18408 Governors Hwy
Homewood, IL 60430
Phone (708) 647-0571

18636 Dixie Hwy
Homewood, IL 60430
Phone (708) 647-0571

3315 W 115th St
Unit C
Merrionette Park, IL 60803
Phone (708) 907-4355

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

1400 Otto Blvd
Sauk Village, IL 60411
Phone (708) 709-2030

101 E Via Ghiglieri
Toluca, IL 61369
Phone (815) 452-2367

510 Oakmont Ln
Westmont, IL 60559
Phone (630) 601-1280

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1093431173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35318 EAGLE WAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606781353",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18408 GOVERNORS HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302911",
            "telephone_number": "708-647-0571",
            "fax_number": "708-647-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3315 W 115th St Unit C",
            "address_purpose": "LOCATION",
            "city": "Merrionette Park",
            "state": "IL",
            "postal_code": "608034556",
            "country_code": "US",
            "telephone_number": "708-907-4355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "888-824-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDONKANG",
        "first_name": "IMAOBONG",
        "middle_name": "PATRICK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.026142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.