Kasiemobi Bernice Okonkwo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036171380 Issued in IL

Practice address

4 Memorial Dr Ste 210
Alton, IL 62002-6704

Phone

(618) 463-5905

Fax

(618) 463-5935

NPI assigned

Jun 28, 2021

Last updated

Feb 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

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 2

Specialty

Hospitalist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Southern Illinois Healthcare Foundation IncGroup PAC ID 1456256874, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Illinois Healthcare Foundation Inc

  dba Centreville Health Center

  • Federally Qualified Health Center (FQHC)
  • Centreville, IL
  • NPI 1609813500

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group NPD
• Southern Illinois Healthcare Foundation Inc

  dba SIHF Healthcare

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IL
  • NPI 1821813247
  NPD
• Southern Illinois Healthcare Foundation, Inc

  dba Windsor Health Center

  • Federally Qualified Health Center (FQHC)
  • East St Louis, IL
  • NPI 1831125038

  Family Medicine

  NPD
• Fairview Heights Medical Group SC

  dba BJC Medical Group of Illinois

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD

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

• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1891365391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620026722",
            "country_code": "US",
            "telephone_number": "618-463-7240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKONKWO",
        "first_name": "KASIEMOBI",
        "middle_name": "BERNICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10077024",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036171380",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036171380",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Memorial Dr",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kasiemobi.okonkwo.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4 Memorial Dr Ste 210",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nurturing Home Care LLC
• NW Rehab, L.L.C.
• Chelsea O'Connell, MSW.LSW
• Katelyn Elizabeth Oexmann, DDS
• Marilyn Ojeda, CRNA
• Oghenero Lucky Olomukoro, PMHNP-BC
• Aaron Patrick Omotola, M.D.
• Mohamedtarek A Omran, BDS
• Marissa Anne Ontis, FNP-C
• Kelsey Marie Orf, AGNP

• Family Medicine Physician in Alton, IL
• Providers in Alton, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.