Gabriel Ifejiasi

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

041487014 Issued in IL

Practice address

20067 Marlin CT
Lynwood, IL 60411-6903

Phone

(708) 308-1702

NPI assigned

Feb 27, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Orbit Health Care Services

  • Nursing Care Agency
  • Lynwood, IL
  • NPI 1427842624
  NPD Authorized official

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1962209759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20067 MARLIN CT",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604116903",
            "telephone_number": "708-308-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20067 MARLIN CT",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604116903",
            "telephone_number": "708-308-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFEJIASI",
        "first_name": "GABRIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IL",
            "license": "041487014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holistic Health and Medical Care Inc
• Moniet Holloway
• Home Images of Illinois
• Homegrown Health Care, Inc.
• Ariel B House, RBT
• Benita Lynnette Ingram, LCSW
• Lakisha Jelks, CERTIFIED NURSE ASST
• Adonius Johnson
• Demar Johnson
• Elizabeth A Johnson, BA, CADC, CODP

• Home Health Registered Nurse in Lynwood, IL
• Providers in Lynwood, IL by specialty
• Home Health Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.