Individual provider Active NPI

Bonaventure I Ogu

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1659220069
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025086017 Issued in IL
Practice address
4554 N Broadway St Ste 218
Chicago, IL 60640-5671
Phone
(773) 554-2490
NPI assigned
Jan 27, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025086017 IL Primary

Addresses

Primary practice location

4554 N Broadway St Ste 218
Chicago, IL 60640-5671

Mailing address

1906 Lee St
Evanston, IL 60202-1537

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
I20260430001112 IL Practitioner - Nurse Practitioner 3779050455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025086017ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seraphic Home Health LLC CurrentSince Sep 21, 2025 Accepting new patients

Locations

4554 N Broadway St
Ste 218
Chicago, IL 60640
Phone (773) 554-2490

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.

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1659220069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 LEE ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4554 N BROADWAY ST STE 218",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405671",
            "telephone_number": "773-554-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGU",
        "first_name": "BONAVENTURE",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "2025086017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.