Onyeisi Stephen Ogbomeh, DNP, APRN-FPA,FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Lake Villa, IL
NPI 1306480025 · NPPES record last updated Jul 30, 2025
Key facts
- NPI
- 1306480025
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209020388 (IL)
- Practice address
- 206 Cedar Ave
Lake Villa, IL 60046-4600 - Phone
- (224) 844-3763
- NPI assigned
- Nov 6, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cardiorenal Therapeutics of Illinois PLLC
Practice addresses (Care Compare)
18 W140 Butterfield Rd
Suite 1558
Oakbrook Terrace, IL 60181-4843
Phone (904) 490-0264
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231101001262 | IL | Practitioner - Nurse Practitioner | 8921454695 | Reassigns benefits to 3 organizations |
| I20231111000360 | TX | Practitioner - Nurse Practitioner | 8921454695 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209020388 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aim Healthcare Providers Il, SC | Current |
Accepting new patients | |
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| Reassure Health PLLC | Family | Current |
Accepting new patients |
Locations
1901 Butterfield Rd
Ste 810
Downers Grove, IL 60515
Phone (484) 494-2465
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209020388 | IL | Yes |
Addresses
Primary practice location
206 Cedar Ave
Lake Villa, IL 60046-4600
Mailing address
206 Cedar Ave
Lake Villa, IL 60046-4600
Phone (773) 791-2317
Other providers in Lake Villa, IL
- Ryan Naes
- Mohamed E Nasr
- Andrilyn Nededog
- Pamela Norley
- Northwest Suburban Urgent Care
- Rosanne Oggoian
- Laura Nancy Ogurek
- Robyn Ondo
- One Goal Wellness, Inc
- One Hope United
All providers in Lake Villa, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.