Glory Obianuju Ikerodah, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

277.002987 Issued in IL

Practice address

1777 E Court St
Kankakee, IL 60901-2670

Phone

(773) 676-4076

NPI assigned

Oct 16, 2018

Last updated

Mar 13, 2024By 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 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sas Surgical LTDGroup PAC ID 8820304322, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048
• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191
• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glory.ikerodah.1@13826.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/683/brand/4/csg/61/fhir/r4

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.

• Sas Surgical LTD.

  • Surgery Physician
  • Harvey, IL
  • NPI 1841676038
  Medicare reassignment Care Compare group NPD
• Chicago Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Orland Park, IL
  • NPI 1285972505
  Medicare reassignment NPD
• Midwest Home Physicians Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1760086540

  IL

  Medicare reassignment NPD
• Pringlow Health and Wellness

  • Primary Care Clinic/Center
  • Mokena, IL
  • NPI 1790497758
  NPD Authorized official
• Pringlow Healthcare PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mokena, IL
  • NPI 1124998364
  NPD Authorized official
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Advocate Health and Hospitals Corporation

  dba Advocate South Suburban Hospital

  • General Acute Care Hospital
  • Hazel Crest, IL
  • NPI 1467560128
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  dba Advocate South Suburban Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1558479212
  Care Compare affiliation
• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation
• St Marys Hospital - Kankakee LLC

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1467290809
  Care Compare affiliation

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1932675006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 E COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012670",
            "telephone_number": "877-692-8686",
            "fax_number": "815-937-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 E COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012670",
            "telephone_number": "773-676-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKERODAH",
        "first_name": "GLORY",
        "middle_name": "OBIANUJU",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018155",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277.002987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmiana McKayla Hughes
• Syed M Hussain, MD
• Sarah Ruth Hussey, RD, LDN
• Samuel Thomas Hutton, PTA
• Nha T Huynh, DO
• Illini Wellness Management
• Illini Wellness Management
• Illinois Anesthesia Associates PC
• Illinois Department of Human (Shapiro Developmental Center Pharmacy)
• Illinois Department of Human Services

• Nurse Practitioner in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.