Adrian Ekomobasi Bifom, MD
Individual provider Active NPI Family Medicine Physician · Springfield, IL
NPI 1740912914 · NPPES record last updated Jun 10, 2025
Key facts
- NPI
- 1740912914
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036173019 (IL)
- Practice address
- 520 N 4TH St
Springfield, IL 62702-5238 - Phone
- (217) 545-8000
- Fax
- (217) 757-8161
- NPI assigned
- Jun 27, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Blessing Hospital
Practice addresses (Care Compare)
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Hospital & facility affiliations
- Blessing Hospital
- MC Donough District Hospital
- Memorial Hospital
- Illini Community Hospital
- Blessing Hospital Snu
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250701001529 | IL | Practitioner - Family Practice |
8820479215 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036173019 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blessing Hospital | Current |
Accepting new patients | |
| Blessing Hospital | Current |
Accepting new patients | |
| Blessing Hospital | Past | Accepting new patients |
Locations
1005 Broadway St
Quincy, IL 62301
Interoperability endpoints
- https://fhir.blessinghospital.com/R4/open-Prod
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125079997 | IL | |
| Family Medicine Physician | 207Q00000X | 036173019 | IL | Yes |
Addresses
Primary practice location
520 N 4TH St
Springfield, IL 62702-5238
Mailing address
PO Box 19670
Springfield, IL 62794-9670
Phone (217) 545-8000
Other practice location 1
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-1200
Other providers in Springfield, IL
- Grace Bibb
- Kellie Bibb
- Lori Ann Bick
- Linda J Biddison
- Robin S Biermann
- Emily Bigelow
- Kimberly Anne Biggs
- Brenda L Bigley
- Ibrahim Makki Binalsheikh
- Martina B. Binder
All providers in Springfield, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.