Individual provider Active NPI

Oluwakemi Magdalene Edoigiawerie, RN, MSN, FNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1699439752
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.024121 Issued in IL
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

Updated by the provider on Sep 22, 2022

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220211001383 IL Practitioner - Nurse Practitioner 7911154059 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
209.024121ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC CurrentSince Nov 9, 2021 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.