Individual provider Active NPI

Chukwuyem Obia, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Maywood, IL
National Provider Identifier
1598224479
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME159581 Issued in FL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 036165418 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036165418 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME159581 FL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

119 Oakfield Dr
Brandon, FL 33511-5779
Phone (813) 681-5551

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cobia232047@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430004120 FL Practitioner - Pathology 4082075601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

1431 SW 1St Ave
Ocala, FL 34471-6558
Phone (352) 401-1134

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036165418ILMDBlood Banking & Transfusion Medicine Physician
ME159581FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince May 1, 2024 Accepting new patients

Locations

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

1431 SW 1st Ave
Ocala, FL 34471
Phone (352) 401-1425

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1598224479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115779",
            "telephone_number": "813-681-5551",
            "fax_number": "813-916-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIA",
        "first_name": "CHUKWUYEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "IL",
            "license": "036165418",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036165418",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME159581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cobia232047@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.