Active NPI
Onyekwelu Edward Chidume
- Specialist
- Homewood, IL
National Provider Identifier
1295970085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 238000213
- Practice address
- 17450 S. Halsted Ave
Ste 260
Homewood, IL 60430 - Phone
- (708) 799-5010
- NPI assigned
- Dec 8, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 238000213 | IL | Primary |
Addresses
Primary practice location
17450 S. Halsted Ave
Ste 260
Homewood, IL 60430
Mailing address
5401 S Hyde Park Blvd
#904
Chicago, IL 60615-5829
Phone (708) 305-2730
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
| License | State | Type | Specialty |
|---|---|---|---|
| 238000213 | IL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228694400000",
"number": "1295970085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 S HYDE PARK BLVD",
"address_2": "#904",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606155829",
"telephone_number": "708-305-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17450 S. HALSTED AVE",
"address_2": "STE 260",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "60430",
"telephone_number": "708-799-5010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIDUME",
"first_name": "ONYEKWELU",
"middle_name": "EDWARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-08",
"last_updated": "2008-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": "238000213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.