Dr Meda Professional Corporation

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

036119419 Issued in IL

Legal business name

DR MEDA PROFESSIONAL CORPORATION

Practice address

1215 N Humphrey Ave
Oak Park, IL 60302-1111

Phone

(708) 378-8079

NPI assigned

Apr 26, 2017

Organization subpart

No

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

Authorized official

Name

Izuchukwu Nwafo

Title

Ceo

Phone

(708) 378-8079

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1679008734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 N HUMPHREY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N HUMPHREY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021111",
            "telephone_number": "708-378-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MEDA PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "NWAFO",
        "authorized_official_first_name": "IZUCHUKWU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-378-8079"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "036119419",
            "primary": true
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.