NPIMap

Individual provider Active NPI

Ifeyinwa Ilechukwu, MD

  • Physical Medicine & Rehabilitation Physician
  • Oak Park, MI
National Provider Identifier
1427165109
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301072967 Issued in MI
Practice address
10350 W 9 Mile Rd
Oak Park, MI 48237-2913
Phone
(248) 541-6630
Fax
(248) 541-6631
NPI assigned
Aug 25, 2006
Last updated
Jul 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301072967 MI Primary

Addresses

Primary practice location

10350 W 9 Mile Rd
Oak Park, MI 48237-2913

Mailing address

10350 W 9 Mile Rd
Oak Park, MI 48237-2913
Phone (248) 541-6630

Other identifiers 6

IdentifierTypeStateIssuer
7900526OtherAETNA HMO
373880OtherAETNA
5594424OtherFIRST HEALTH NETWORK
000000013644OtherCAPE
250823437OtherMIBLUE CROSS OF MI
4695533MedicaidMI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301072967MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Herbert Isaac Clinic PLLC PastSince Nov 1, 2010 Accepting new patients
New Image Body and Wellness Clinic, PC Past Accepting new patients
Oakland Health Associate of Waterford Clarkston PastSince Apr 19, 2025 Accepting new patients
Dial a Doc PC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1427165109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 W 9 MILE RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372913",
            "telephone_number": "248-541-6630",
            "fax_number": "248-541-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 W 9 MILE RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372913",
            "telephone_number": "248-541-6630",
            "fax_number": "248-541-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILECHUKWU",
        "first_name": "IFEYINWA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301072967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "7900526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "373880",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK",
            "identifier": "5594424",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE",
            "identifier": "000000013644",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MI",
            "identifier": "250823437",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4695533",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.