Chicagoland Infectious Disease PC
Organization Active NPI Infectious Disease Physician · South Holland, IL
NPI 1780002352 · NPPES record last updated Dec 30, 2021
Key facts
- NPI
- 1780002352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- License
- 036119718 (IL)
- Legal business name
- CHICAGOLAND INFECTIOUS DISEASE PC
- Practice address
- 430 E 162ND St
#487
South Holland, IL 60473-2258 - Phone
- (312) 504-5757
- NPI assigned
- Apr 1, 2014
- Organization subpart
- No
Authorized official
- Name
- Olufemi Aboyeji, MD
- Title
- President
- Phone
- (708) 960-4280
Practitioners 72
-
Olufemi Aboyeji, MD
-
Ngozi Adindu, NP
-
Wyvon Blackwell, MSN, APRN,FNP-C
-
Veronica Broger-Dunner, MSN, FNP-BC
-
Regina Brown, NP
-
Taryrsha Davis, APN
-
Dyenina Daleon Donnelly, FNP-BC
-
Hillari Hanley, APRN-BC
-
Evelyn Jones, APRN
-
Rachel Kurrella, FNP-BC
-
Karin J Lee-Campbell, FNP-BC
-
Aline Denise Nelson, FNP
-
Christine A Offerman-Izzarelli, NURSE PRACTITIONER
-
Chinyere Okoroh, FNP
-
Hardi Patel, FNP-C
-
Trupti Patel, APN-CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140516001062 | IL | Part B Supplier - Clinic/Group Practice | 5193948362 |
Receives reassigned benefits from 56 practitioners Practice locations: Harvey, IL; Hazel Crest, IL; Hobart, IN; Homewood, IL; Itasca, IL; Lansing, IL; Naperville, IL; New Lenox, IL… |
| O20150205000149 | IN | Part B Supplier - Clinic/Group Practice | 5193948362 |
Receives reassigned benefits from 20 practitioners Practice locations: Hobart, IN; Whiting, IN; Munster, IN; Merrillville, IN; La Porte, IN; Gary, IN; Dyer, IN; Crown Point, IN |
National Provider Directory
Locations
833 E 158th St
Ste 5
Dolton, IL 60419
17901 Governors Hwy
Ste 206
Homewood, IL 60430
Phone (708) 957-9100
245 W Johnson Rd
Ste 7
La Porte, IN 46350
Phone (219) 262-0037
Interoperability endpoints
- oaboyeji261669@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician |
207RI0200X | 036119718 | IL | Yes |
Addresses
Primary practice location
430 E 162ND St
#487
South Holland, IL 60473-2258
Mailing address
430 E 162ND St
#487
South Holland, IL 60473-2258
Phone (708) 960-4280
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | oaboyeji261669@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | oaboyeji261669@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in South Holland, IL
- Gisele Marie Casanova
- Centers for Residential Alternatives
- Charles Matt Chelich LTD
- Edwige Charles
- Charles Matthew Chelich
- Froncell Childred Kirkling
- Childrens Mansion Corp
- Chirospaaah
- Christian Community Health Center
- Christian Community Home Health Professionals, LLC
All providers in South Holland, IL · Infectious Disease 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 Dec 30, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.