Uwaila Iyengunmwena Iredia
Individual provider Active NPI Nurse Practitioner · Olympia FLDS, IL
NPI 1366068520 · NPPES record last updated Jun 1, 2022
Key facts
- NPI
- 1366068520
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 06200631 (IL)
- Practice address
- 3242 Cumberland TRL
Olympia FLDS, IL 60461-1118 - Phone
- (773) 814-5690
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- HDC Care Solutions LLC
Value Based Long Term Care H PC
Practice addresses (Care Compare)
332 S Michigan Ave
FL 4
Chicago, IL 60604-4434
Phone (888) 964-6681
332 S Michigan Ave
Suite 900
Chicago, IL 60604-4393
Phone (888) 964-6681
Hospital & facility affiliations
- Riverside Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- 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 |
|---|---|---|---|---|
| I20240229000727 | IL | Practitioner - Nurse Practitioner | 5597100545 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06200631 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altea Medical Illinois PLLC | Current |
Accepting new patients | |
| HDC Care Solutions, LLC | Nurse Practitioner | Current |
Accepting new patients |
| Value Based Long Term Care H PC | Current |
Accepting new patients | |
| Post Acute Medical PLLC | Current |
Accepting new patients | |
| Healthdrive Medical Services Southeast LLC | Nurse Practitioner | Current |
Accepting new patients |
Locations
400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297
332 S Michigan Ave
Ste 800
Chicago, IL 60604
332 S Michigan Ave
Ste 900
Chicago, IL 60604
Phone (813) 395-1073
332 S Michigan Ave
Fl 4
Chicago, IL 60604
490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444
3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400
1101 E State St
Geneva, IL 60134
Phone (630) 208-1876
555 W Carpenter St
Springfield, IL 62702
Phone (217) 525-1880
100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486
Interoperability endpoints
- ms_uiyengu1@landmarkhealth-direct.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 06200631 | IL | Yes |
Addresses
Primary practice location
3242 Cumberland TRL
Olympia FLDS, IL 60461-1118
Mailing address
50 S B B King Blvd Ste 100
Memphis, TN 38103-2626
Phone (901) 436-1381
Other providers in Olympia FLDS, IL
All providers in Olympia FLDS, IL · 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 Jun 1, 2022. 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.