Vivian Nnenna Chukwuma, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.077859 Issued in IL

Practice address

4220 West 95TH Street
Suite 200
Oak Lawn, IL 60453

Phone

(708) 398-0287

Fax

(708) 684-2032

NPI assigned

Jun 3, 2021

Reactivated

Jun 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1477129062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 WEST 95TH STREET",
            "address_2": "SUITE 200",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-398-0287",
            "fax_number": "708-684-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 WEST 95TH STREET",
            "address_2": "SUITE 200",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-398-0287",
            "fax_number": "708-684-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUKWUMA",
        "first_name": "VIVIAN",
        "middle_name": "NNENNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "deactivation_date": "2023-04-03",
        "reactivation_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.077859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina J. Levi O D P C (Advanced Eye Care)
• Alan Robert Christopher, D.D.S.
• Foti T Chronopoulos, MD
• Chalese Chudzinski, PT, DPT
• Victor Sopuruchi Chukwueke, MD
• Nancy R G Church, M.D.
• Rasa Ciceniene, M.A., LCPC
• Mitchell Ciesla, RPH
• Stephania Anna Cieslak, RN
• Enrique Guillermo Cifuentes, M.D.

• Internal Medicine Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.