Benedict Ikeudenta III, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036181027 Issued in IL

Practice address

7702 N Alpine Rd
Loves Park, IL 61111-3107

Phone

(815) 971-3310

NPI assigned

Mar 23, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: bikeudenta103333@direct.mhemail.org

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1477256931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7561 CREEK BND",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146663",
            "telephone_number": "346-322-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 N ALPINE RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113107",
            "telephone_number": "815-971-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEUDENTA",
        "first_name": "BENEDICT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036181027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hoosier Care, Inc.
• Cheryl Lynn Horkheimer, LMT
• Jason Huffman, CRNA
• Jennifer Huls, LMT
• Ibrahim Ibrahim, M.D.
• Illinois Mentor
• Sheila Isit, PHARMACIST
• Tarica Rashaun Jackson, LCSW
• Salli Jacobsen
• Samuel Janczak, LMT

• Family Medicine Physician in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.