Individual provider Active NPI

Chibuzor Nonye Opara, MD

  • Neonatal-Perinatal Medicine Physician
  • Peoria, IL
National Provider Identifier
1346680766
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
036139878 Issued in IL
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-3723
Phone
(856) 782-2212
Fax
(856) 782-2266
NPI assigned
Jun 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125063532 IL
Neonatal-Perinatal Medicine Physician 2080N0001X 036139878 IL Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-3723

Mailing address

1000 Haddonfield Berlin Rd Ste 210
Voorhees, NJ 08043-3520
Phone (856) 782-2212

Other practice location 1

1900 W Polk St
Rm #1134
Chicago, IL 60612-3723
Phone (312) 864-4505

Other identifiers 1

IdentifierTypeStateIssuer
036139878MedicaidIL

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
I20160307002637 IL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0446556195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125063532ILMDPediatrics Physician
036139878ILMDNeonatal-Perinatal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1346680766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD STE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616363723",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 W Polk St",
            "address_2": "Rm #1134",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123723",
            "country_code": "US",
            "telephone_number": "312-864-4505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPARA",
        "first_name": "CHIBUZOR",
        "middle_name": "NONYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-29",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125063532",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036139878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036139878",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.