NPIMap

Individual provider Active NPI

Chukwueloka Ikedionwu, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1457468019
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036103454 Issued in IL
Practice address
500 E 51St St
Chicago, IL 60615-2400
Phone
(312) 572-2673
Fax
(312) 572-2669
NPI assigned
Aug 23, 2006
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036103454 IL Primary

Addresses

Primary practice location

500 E 51St St
Chicago, IL 60615-2400

Mailing address

11918 S 69TH CT
Palos Heights, IL 60463-1634
Phone (708) 361-2804

Other identifiers 1

IdentifierTypeStateIssuer
03610345402MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eikedionwu@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070914000657 IL Practitioner - Family Practice 2567556020 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians
New Rose Healthcare Management LLCGroup PAC ID 4981010048, 18 clinicians
Loretto HospitalGroup PAC ID 5193725893, 38 clinicians

Practice addresses (Care Compare)

1135 W 69TH St
Chicago, IL 60621-1147
Phone (773) 483-5011

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

45 W 111TH St
Chicago, IL 60628-4200
Phone (773) 995-3000

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

645 S Central Ave
Chicago, IL 60644-5059
Phone (773) 854-5567

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Rose Healthcare Management LLC CurrentSince Jan 29, 2021 Accepting new patients
Loretto Hospital CurrentSince Dec 20, 2021 Accepting new patients
Cook County Current Accepting new patients
Emergency Medical Specialists, II, S.C. CurrentSince Aug 4, 2015 Accepting new patients
Cook County Family Medicine CurrentSince Jun 21, 2017 Accepting new patients
Cook County CurrentSince Jun 21, 2017 Accepting new patients
Fola Community Action Services Inc. CurrentSince Jan 29, 2016 Accepting new patients
Suburban Emergency Physicians Group, SC Past Accepting new patients
Emergency Room Care Providers, S.C. PastSince Jul 25, 2019 Accepting new patients
24 Ihim LLC PastSince Jul 25, 2019 Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

1900 W Polk St
Ste 1200
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

25706 Network Pl
Chicago, IL 60673

3435 W Van Buren St
Chicago, IL 60624
Phone (773) 265-7700

34816 Eagle Way
Chicago, IL 60678

45 W 111th St
Chicago, IL 60628
Phone (773) 995-3000

4909 W Division St
Chicago, IL 60651
Phone (773) 854-8000

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

645 S Central Ave
Chicago, IL 60644
Phone (773) 626-4300

5601 S County Line Rd
Hinsdale, IL 60521
Phone (630) 286-4000

900 Oakmont Ln
Ste 100
Westmont, IL 60559

Organizations & group practices 11

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.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1457468019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11918 S 69TH CT",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631634",
            "telephone_number": "708-361-2804",
            "fax_number": "708-361-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 51ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152400",
            "telephone_number": "312-572-2673",
            "fax_number": "312-572-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEDIONWU",
        "first_name": "CHUKWUELOKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03610345402",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eikedionwu@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.