Individual provider Active NPI

Obianuju Sandra Madueke-Laveaux, M.D.

  • Gynecology Physician
  • Chicago, IL
National Provider Identifier
1295032555
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
036144211 Issued in IL
Practice address
5841 S Maryland Ave # Mc2050
Chicago, IL 60637-1443
Phone
(773) 834-7885
NPI assigned
Feb 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 036144211 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc2050
Chicago, IL 60637-1443

Mailing address

150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965
Phone (773) 702-1061

Other names 1

  • Obianuju Sandra Madueke Former name

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
I20170929001858 IL Practitioner - Obstetrics/Gynecology 3971815879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The University of Chicago Medical CenterGroup PAC ID 7618880766, 907 clinicians
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

Hospital & facility affiliations

  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036144211ILMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Feb 18, 2018 Accepting new patients
University of Chicago CurrentSince Aug 31, 2017 Accepting new patients
The University of Chicago Medical Center CurrentSince Feb 18, 2018 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

19550 Governors Hwy
Ste 3800
Flossmoor, IL 60422

19550 Governors Hwy
Flossmoor, IL 60422
Phone (708) 799-8400

71 W 156th St
Ste 309
Harvey, IL 60426
Phone (708) 331-1122

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: omaduekelaveaux155729@uchospital.direct-ci.com

Organizations & group practices 7

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

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": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1295032555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965",
            "telephone_number": "773-702-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC2050",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUEKE-LAVEAUX",
        "first_name": "OBIANUJU",
        "middle_name": "SANDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036144211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OBIANUJU",
            "last_name": "MADUEKE",
            "middle_name": "SANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.