Individual provider Active NPI

Adaku Ngozika Madubuko, APN,NP

  • Adult Health Clinical Nurse Specialist
  • Chicago, IL
National Provider Identifier
1649569948
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
209.005994 Issued in IL
Practice address
MD at Home
2003 W Fulton
Chicago, IL 60612
Phone
(312) 850-3437
NPI assigned
Apr 7, 2011
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 209.005994 IL Primary

Addresses

Primary practice location

MD at Home
2003 W Fulton
Chicago, IL 60612

Mailing address

MD at Home
2003 W Fulton St
Chicago, IL 60612
Phone (312) 850-3437

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
I20120508000168 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 1456513555 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD @ Home Illinois, SCGroup PAC ID 7810167830, 53 clinicians
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

2003 W Fulton St
Suite 303
Chicago, IL 60612-2345
Phone (312) 243-2223

66 W Oak St
Chicago, IL 60610-7325
Phone (312) 705-5100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.005994ILMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC CurrentSince Nov 15, 2022 Accepting new patients
MD @ Home Illinois, SC CurrentSince May 22, 2023 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Dec 4, 2011 Accepting new patients
Cook County CurrentSince Dec 4, 2011 Accepting new patients
Home Physicians PC PastSince Nov 20, 2022 Accepting new patients

Locations

1900 W Polk St
Chicago, IL 60612
Phone (312) 864-0060

1900 W Polk St
Fl 9
Chicago, IL 60612
Phone (312) 864-4417

1900 W Polk St
Ste 1200
Chicago, IL 60612

1900 W Polk St
Ste 220C
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

2003 W Fulton St
Ste 303
Chicago, IL 60612
Phone (312) 243-2223

25706 Network Pl
Chicago, IL 60673

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

4909 W Division St
Chicago, IL 60651
Phone (773) 854-8000

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

66 W Oak St
Chicago, IL 60610
Phone (312) 337-5400

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1649569948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MD AT HOME",
            "address_2": "2003 W FULTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-850-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MD AT HOME",
            "address_2": "2003 W FULTON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-850-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUBUKO",
        "first_name": "ADAKU",
        "middle_name": "NGOZIKA",
        "name_prefix": "Dr.",
        "credential": "APN,NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "209.005994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.