Ijeamaka Ezebilo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036164272 Issued in IL

Practice address

405 W Jackson St Dept of
Carbondale, IL 62901-1467

Phone

(618) 549-0721

NPI assigned

Mar 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice of Southern Illinois, Inc Hospice, Belleville, IL, CCN 141504
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
• Pinckneyville Community Hospital Hospital, Pinckneyville, IL, CCN 141307
• Herrin Hospital Hospital, Herrin, IL, CCN 140011

Merit-based Incentive Payment System (MIPS)

Final score

88.96 of 100Reported as group

Quality

77.5

Improvement activities

40

Cost

74.58

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• 24 On Physicians, PC

  • Hospitalist Physician
  • Ottawa, IL
  • NPI 1346480431
  Medicare reassignment Care Compare group NPD
• 24 On Physicians, P.C.

  • Hospitalist Physician
  • Attleboro, MA
  • NPI 1790104511
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospice of Southern Illinois, Inc.

  • Community Based Hospice Care Agency
  • Belleville, IL
  • NPI 1720081805
  Care Compare affiliation
• Pinckneyville Community Hospital

  • Critical Access Hospital
  • Pinckneyville, IL
  • NPI 1689646523
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1760010649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST DEPT OF",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011467",
            "telephone_number": "618-549-0721",
            "fax_number": "410-554-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST DEPT OF",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011467",
            "telephone_number": "618-549-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEBILO",
        "first_name": "IJEAMAKA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036164272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Etherington, DO
• Dave Scott Evans, MS, CADC
• Tamblyn Everett, BA
• Expressions of Faith, Incorporated
• Theresa Eytalis, L.C.S.W.
• Anne E. Fairfield, P.A.-C.
• Amanda Fairless, ADN, RN
• Fairview Heights Medical Group SC
• Mostafa Abdul-Rahman Farache, MD
• Elsie Farough

• Internal Medicine Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.