Individual provider Active NPI

Lawrence Okafor, M.D.

  • Internal Medicine Physician
  • South Holland, IL
National Provider Identifier
1285649012
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-050121 Issued in IL
Practice address
100 W 162ND St
South Holland, IL 60473-2003
Phone
(708) 210-0613
Fax
(708) 210-0648
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-050121 IL Primary

Addresses

Primary practice location

100 W 162ND St
South Holland, IL 60473-2003

Mailing address

2311 W 22ND St
Suite 202
Oak Brook, IL 60523-1225

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000195 IL Practitioner - Internal Medicine 9335334812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-050121ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1285649012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 W 22ND ST",
            "address_2": "SUITE 202",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732003",
            "telephone_number": "708-210-0613",
            "fax_number": "708-210-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAFOR",
        "first_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-050121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

Verify at the official NPI Registry.