Active NPI
Oluwakemi Magdalene Edoigiawerie, RN, MSN, FNP
- Family Nurse Practitioner
- Chicago, IL
National Provider Identifier
1699439752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.024121
- Practice address
- 3622 S Giles Ave
Chicago, IL 60653-1108 - Phone
- (312) 952-7795
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.024121 | IL | Primary |
Addresses
Primary practice location
3622 S Giles Ave
Chicago, IL 60653-1108
Mailing address
50 S B B King Blvd # 100
Memphis, TN 38103-2626
Phone (901) 436-1381
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.024121 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitae Health Medical Illinois, PLLC | Current | Accepting new patients |
Locations
3601 S Harlem Ave
Berwyn, IL 60402
Phone (708) 484-1486
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
Interoperability endpoints
- ms_oedoigia@landmarkhealth-direct.org
Organizations & group practices 1
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.
-
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- Skokie, IL
- NPI 1174013452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1699439752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 S B B KING BLVD # 100",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381032626",
"telephone_number": "901-436-1381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3622 S GILES AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606531108",
"telephone_number": "312-952-7795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDOIGIAWERIE",
"first_name": "OLUWAKEMI",
"middle_name": "MAGDALENE",
"credential": "RN, MSN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.024121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.