Individual provider Active NPI

Kate Anayochukwu Onyibor, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • South Elgin, IL
National Provider Identifier
1801895701
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036-107699 Issued in IL
Practice address
746 W Spring St
South Elgin, IL 60177-1424
Phone
(224) 357-6997
Fax
(224) 227-7312
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036-107699 IL Primary

Addresses

Primary practice location

746 W Spring St
South Elgin, IL 60177-1424

Mailing address

746 W Spring St
South Elgin, IL 60177-1424
Phone (224) 357-6997

Other identifiers 1

IdentifierTypeStateIssuer
036-107699MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080317000200 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2961470836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-107699ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Popular Home Care LLC Current Accepting new patients
Support Home Health Care LLC CurrentSince Jun 6, 2021 Accepting new patients
Seniorcare Medical Group LLC Geriatric Medicine CurrentSince Nov 19, 2018 Accepting new patients
Our Lady of the Lake Hospital Inc Geriatric Medicine Past Accepting new patients
Inpatient Medical Services, PC Hospitalist Past Accepting new patients
Inpatient Consultants of Tennessee, P.C. Hospitalist Past Accepting new patients

Locations

746 W Spring St
South Elgin, IL 60177
Phone (847) 697-0565

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Support Home Health Care LLCHoffman Estates, IL, CCN 148400 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Director (75%)
W-2 Managing Employee (50%)
Jun 6, 2021
Jun 6, 2021
Jun 6, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1801895701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 W SPRING ST",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601771424",
            "telephone_number": "224-357-6997",
            "fax_number": "224-227-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 W SPRING ST",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601771424",
            "telephone_number": "224-357-6997",
            "fax_number": "224-227-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYIBOR",
        "first_name": "KATE",
        "middle_name": "ANAYOCHUKWU",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036-107699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-107699",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

Verify at the official NPI Registry.