Individual provider Active NPI

Chinyere Okoroh, FNP

  • Family Nurse Practitioner
  • Elmhurst, IL
National Provider Identifier
1700102647
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.007787 Issued in IL
Practice address
977 N Oaklawn Ave
Suite 104
Elmhurst, IL 60126-1045
Phone
(630) 832-1775
Fax
(630) 832-3078
NPI assigned
Apr 16, 2010
Last updated
Apr 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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 209.007787 IL Primary

Addresses

Primary practice location

977 N Oaklawn Ave
Suite 104
Elmhurst, IL 60126-1045

Mailing address

15629 Drexel Ave
Dolton, IL 60419-2751
Phone (708) 261-2166

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
I20100602000290 IL Practitioner - Nurse Practitioner 0345379277 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicagoland Infectious Disease PCGroup PAC ID 5193948362, 38 clinicians

Practice addresses (Care Compare)

430 E 162ND St
Suite 487
South Holland, IL 60473-2258
Phone (708) 880-0559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.007787ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Family CurrentSince Aug 15, 2015 Accepting new patients
Chicagoland Infectious Disease PC CurrentSince Nov 1, 2015 Accepting new patients
United Medical Group, SC PastSince Jul 25, 2017 Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

1333 Burr Ridge Pkwy
Ste 200
Burr Ridge, IL 60527
Phone (630) 308-8706

977 N Oaklawn Ave
Ste 104
Elmhurst, IL 60126
Phone (800) 683-7861

430 E 162nd St
South Holland, IL 60473
Phone (312) 504-5757

Organizations & group practices 4

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": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1700102647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15629 DREXEL AVE",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192751",
            "telephone_number": "708-261-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 N OAKLAWN AVE",
            "address_2": "SUITE 104",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261045",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOROH",
        "first_name": "CHINYERE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.007787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.