Individual provider Active NPI

Adesuwa Omone Ighodaro, M.D.

  • Hospitalist Physician
  • Oak Lawn, IL
National Provider Identifier
1811627029
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01095815A Issued in IN
Practice address
4220 W. 95TH Street
Suite 200
Oak Lawn, IL 60453
Phone
(708) 398-0287
Fax
(708) 684-2032
NPI assigned
Jun 13, 2022
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125081030 IL
Hospitalist Physician 208M00000X 01095815A IN Primary

Addresses

Primary practice location

4220 W. 95TH Street
Suite 200
Oak Lawn, IL 60453

Mailing address

4220 W. 95TH Street
Suite 200
Oak Lawn, IL 60453
Phone (708) 398-0287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250807004122 IN Practitioner - Hospitalist 3375041544 Reassigns benefits to 1 organization
I20250815000416 KY Practitioner - Hospitalist 3375041544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

1305 N Elm St
Henderson, KY 42420-2783
Phone (270) 827-7474

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-7299

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125081030ILMDInternal Medicine Physician
01095815AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital Inc Hospitalist CurrentSince Aug 1, 2025 Accepting new patients
Deaconess Hospital, Inc Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Deaconess Hospital Inc CurrentSince Aug 1, 2025 Accepting new patients
Methodist Health, Inc. Past Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

1305 N Elm St
Henderson, KY 42420
Phone (270) 827-7100

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1811627029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 W. 95TH STREET",
            "address_2": "SUITE 200",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-398-0287",
            "fax_number": "708-684-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W. 95TH STREET",
            "address_2": "SUITE 200",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-398-0287",
            "fax_number": "708-684-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGHODARO",
        "first_name": "ADESUWA",
        "middle_name": "OMONE",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125081030",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01095815A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.