Individual provider Active NPI

Richard A Egwele, M.D.

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1306991310
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
207Q00000X Issued in IL
Practice address
9135 S Exchange Ave
Chicago, IL 60617-4225
Phone
(773) 374-2441
Fax
(773) 374-7652
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 207Q00000X IL Primary

Addresses

Primary practice location

9135 S Exchange Ave
Chicago, IL 60617-4225

Mailing address

PO Box 17578
Chicago, IL 60617-0578
Phone (773) 374-2441

Other identifiers 2

IdentifierTypeStateIssuer
21607598OtherILBLUE CROSS BLUE SHIELD
036051741MedicaidIL

Other names 1

  • Dr. Richard Egwele Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120606000395 IL Practitioner - Orthopedic Surgery 2567361389 Reassigns benefits to 2 organizations
I20190530001488 IN Practitioner - Orthopedic Surgery 2567361389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
207Q00000XILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameriwound Physicians in LLC CurrentSince Mar 27, 2019 Accepting new patients
Healogics Specialty Physicians of Illinois, LLC CurrentSince Sep 1, 2020 Accepting new patients
Ameriwound Physicians Il LLC CurrentSince Oct 17, 2017 Accepting new patients
Advocate Health Centers, Inc. Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

3518 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0358

1101 E Coolspring Ave
Michigan City, IN 46360
Phone (219) 874-5211

6150 Parkland Blvd
Ste 225
Mayfield Hts, OH 44124

5800 Landerbrook Dr
Ste 220
Mayfield Hts, OH 44124

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1306991310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17578",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606170578",
            "telephone_number": "773-374-2441",
            "fax_number": "773-374-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-374-2441",
            "fax_number": "773-374-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGWELE",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "207Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21607598",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051741",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "EGWELE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.