NPIMap

Individual provider Active NPI

Victor Nnadozie Udechukwu, M.D

  • Gastroenterology Physician
  • Hazel Crest, IL
National Provider Identifier
1871900589
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036.142756 Issued in IL
Practice address
17850 Kedzie Ave Ste 3500
Hazel Crest, IL 60429-2082
Phone
(708) 957-4011
NPI assigned
Jul 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-142756 IL
Hospitalist Physician 208M00000X 036-142756 IL
Gastroenterology Physician 207RG0100X 036.142756 IL Primary

Addresses

Primary practice location

17850 Kedzie Ave Ste 3500
Hazel Crest, IL 60429-2082

Mailing address

29373 Network PL
Chicago, IL 60673-1298
Phone (847) 390-5900

Other practice location 1

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 864-6000

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address vudechukwu@direct.ccprovider.org Direct Cook County
Direct Messaging Address vudechukwu403910@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170727000112 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 7719283456 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Anthony Health AffiliatesGroup PAC ID 1254321474, 95 clinicians

Practice addresses (Care Compare)

17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 684-5340

17850 Kedzie Ave
Suite 2200
Hazel Crest, IL 60429-2056
Phone (708) 873-8476

17850 S Kedzie Ave
Suite 2100
Hazel Crest, IL 60429-2056
Phone (708) 684-5630

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

2875 W 19TH St
Chicago, IL 60623-3501
Phone (773) 484-4425

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy68
Upper gastrointestinal (GI) endoscopy for acid reflux46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-142756ILMDInternal Medicine Physician
036.142756ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Anthony Hospital CurrentSince Dec 18, 2020 Accepting new patients
Cook County CurrentSince Jun 23, 2017 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jul 1, 2024 Accepting new patients
Saint Anthony Health Affiliates Hospitalist CurrentSince Dec 18, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Cook County Internal Medicine CurrentSince Jun 23, 2017 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2024 Accepting new patients
Cook County Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

4177 S Archer Ave
Chicago, IL 60632
Phone (773) 254-2222

29373 Network Pl
Chicago, IL 60673

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1900 W Polk St
Ste 220C
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

17850 Kedzie Ave
Ste 3500
Hazel Crest, IL 60429
Phone (708) 799-8585

Interoperability endpoints

  • Direct secure messaging: vudechukwu@direct.ccprovider.org
  • Direct secure messaging: vudechukwu403910@direct.myadvocateaurora.org

Organizations & group practices 8

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.

Hospital & facility affiliations 12

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1871900589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731298",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 KEDZIE AVE STE 3500",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292082",
            "telephone_number": "708-957-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 W Harrison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123714",
            "country_code": "US",
            "telephone_number": "312-864-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDECHUKWU",
        "first_name": "VICTOR",
        "middle_name": "NNADOZIE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-142756",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-142756",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.142756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vudechukwu@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vudechukwu403910@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17850 Kedzie Ave Ste 3500",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "17850 Kedzie Ave Ste 3500",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

Verify at the official NPI Registry.