Individual provider Active NPI

Stella Ogbonna

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1245103662
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209032796 Issued in IL
Practice address
5461 W Lake Street
Chicago, IL 60644
Phone
(773) 378-3347
NPI assigned
Sep 24, 2025
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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 209032796 IL Primary

Addresses

Primary practice location

5461 W Lake Street
Chicago, IL 60644

Mailing address

5461 W Lake Street
Chicago, IL 60644

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
I20251023001197 IL Practitioner - Nurse Practitioner 1951899756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians

Practice addresses (Care Compare)

14 Lake St
Oak Park, IL 60302-2606
Phone 7083830113220005

5425 W Lake St
Chicago, IL 60644-2342
Phone (773) 413-1920

5461 W Lake St
Chicago, IL 60644-2342
Phone 7083830113220005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209032796ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Community Wellness Center CurrentSince Oct 15, 2025 Accepting new patients
PCC Community Wellness Center CurrentSince Oct 15, 2025 Accepting new patients

Locations

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

Interoperability endpoints

  • Direct secure messaging: stella.ogbonna.1@13158.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1245103662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 W LAKE STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 W LAKE STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60644",
            "telephone_number": "773-378-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBONNA",
        "first_name": "STELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209032796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.