Magnus E Edosomwan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036085865 Issued in IL

Practice address

1738 W 99TH St
Chicago, IL 60643-2116

Phone

(773) 233-2408

NPI assigned

Jul 23, 2006

Last updated

Dec 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cook County

  dba John H. Stroger, Jr. Hospital of Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Humboldt Park Health

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1740417153

  Internal Medicine

  Medicare reassignment NPD
• Cook County

  dba Cook County Health & Hospitals System Physician Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170

  Internal Medicine

  NPD
• Cook County

  dba Bronzeville Health Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• Jubilee Adult Day Center Inc

  • Adult Day Care Clinic/Center
  • Chicago, IL
  • NPI 1396703021

  Internal Medicine

  NPD (past)
• Lakeshorehealthcare

  • Group Psychotherapy Psychologist
  • Chicago, IL
  • NPI 1881643906
  NPD (past)
• Medplus, S.C.

  • Internal Medicine Physician
  • Des Plaines, IL
  • NPI 1770538753
  NPD (past)

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1215959176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 W 99TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432116",
            "telephone_number": "773-233-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDOSOMWAN",
        "first_name": "MAGNUS",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036085865",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-085865",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085865",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edna Richard M D
• Charles Edoigiawerie, M.D.
• Olivia Edoigiawerie
• Oluwakemi Magdalene Edoigiawerie, RN, MSN, FNP
• Sylvia Uwaila Edoigiawerie, MD-PHD
• Edp of Wisconsin, SC (Elite Dental Partners)
• Webster Montano Edpao, M.D.
• Michael L Edquiban, PT
• Laura Edquist
• Nekaela Edralin, DMD

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.