Individual provider Active NPI

Chibuzor Emmanuel Odigili

  • Adult Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1285438390
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
00005512 Issued in WI
Practice address
303 W Coventry CT
Milwaukee, WI 53217-3971
Phone
(414) 210-1725
NPI assigned
Apr 1, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 00005512 WI Primary

Addresses

Primary practice location

303 W Coventry CT
Milwaukee, WI 53217-3971

Mailing address

303 W Coventry CT
Milwaukee, WI 53217-3971
Phone (414) 210-1725

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

LicenseStateTypeSpecialty
00005512WIMDAdult Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1285438390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W COVENTRY CT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173971",
            "telephone_number": "414-210-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W COVENTRY CT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173971",
            "telephone_number": "414-210-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODIGILI",
        "first_name": "CHIBUZOR",
        "middle_name": "EMMANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "WI",
            "license": "00005512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.