Individual provider Active NPI

Christian B Oyibe

  • Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1528423019
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209013679 Issued in IL
Practice address
9750 Crescent Park Cir Unit 129
Orland Park, IL 60462-7500
Phone
(708) 770-6228
Fax
(708) 249-6343
NPI assigned
Dec 28, 2015
Last updated
May 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209013679 IL Primary

Addresses

Primary practice location

9750 Crescent Park Cir Unit 129
Orland Park, IL 60462-7500

Mailing address

2158 45TH St # 519
Highland, IN 46322-3742
Phone (855) 276-5212

Other identifiers 1

IdentifierTypeStateIssuer
277000852OtherILSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112001902 IL Practitioner - Nurse Practitioner 3375845027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Southtown Medical Group S CGroup PAC ID 0547572349, 12 clinicians

Practice addresses (Care Compare)

8205 Cass Ave
Suite 110B
Darien, IL 60561-5319
Phone (773) 840-4747

9750 Crescent Park Cir
Unit 129
Orland Park, IL 60462-7500
Phone (708) 204-7612

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.65 of 100Reported as group
Quality
52.24
Promoting interoperability
42
Improvement activities
40
Cost
58.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rex Medical Services LLC Internal Medicine CurrentSince Aug 1, 2016 Accepting new patients
New Southtown Medical Group S C CurrentSince Dec 12, 2015 Accepting new patients
Physicians Medical Services, LTD. Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients
Illiana Home Physician Services Inc PastSince Dec 1, 2019 Accepting new patients

Locations

8205 Cass Ave
Ste 110B
Darien, IL 60561
Phone (773) 840-4747

2158 45th St
Highland, IN 46322
Phone (219) 554-0500

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1528423019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 45TH ST # 519",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223742",
            "telephone_number": "855-276-5212",
            "fax_number": "888-668-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 CRESCENT PARK CIR UNIT 129",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604627500",
            "telephone_number": "708-770-6228",
            "fax_number": "708-249-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYIBE",
        "first_name": "CHRISTIAN",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-28",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "277000852",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.