Active NPI
Kelvin V Udogu, PHARM D
- Pharmacist
- Bolingbrook, IL
National Provider Identifier
1609157262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.289588
- Practice address
- 101 Lily Cache LN
Bolingbrook, IL 60440-4895 - Phone
- (630) 759-3011
- NPI assigned
- Sep 8, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.289588 | IL | Primary |
| Pharmacist | 183500000X | 26021584A | IN | |
| Pharmacist | 183500000X | 2005005260 | MO |
Addresses
Primary practice location
101 Lily Cache LN
Bolingbrook, IL 60440-4895
Mailing address
11550 S Olympic Dr
Plainfield, IL 60585-6146
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.289588 | IL | MD | Pharmacist |
| 26021584A | IN | MD | Pharmacist |
| 2005005260 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Global Medical Services LLC | Current | Accepting new patients | |
| Global Medical Services LLC | Current | Accepting new patients |
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.
-
- Durable Medical Equipment & Medical Supplies
- Elgin, IL
- NPI 1598190936
-
- Community/Retail Pharmacy
- Plainfield, IL
- NPI 1891231049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315440000000",
"number": "1609157262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11550 S OLYMPIC DR",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605856146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 LILY CACHE LN",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404895",
"telephone_number": "630-759-3011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDOGU",
"first_name": "KELVIN",
"middle_name": "V",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-08",
"last_updated": "2011-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.289588",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26021584A",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2005005260",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.