Individual provider Active NPI

Jude Udagwua, FNP-BC

  • Family Nurse Practitioner
  • Des Plaines, IL
National Provider Identifier
1982313318
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209026377 Issued in IL
Practice address
31 W Millers Rd
Des Plaines, IL 60016-2844
Phone
(773) 559-0842
NPI assigned
Nov 15, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209026377 IL Primary

Addresses

Primary practice location

31 W Millers Rd
Des Plaines, IL 60016-2844

Mailing address

31 W Millers Rd
Des Plaines, IL 60016-2844
Phone (773) 559-0842

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221223000886 IL Practitioner - Nurse Practitioner 9739559386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians
Cardiorenal Therapeutics of Illinois PLLCGroup PAC ID 5395159677, 32 clinicians

Practice addresses (Care Compare)

1601 N Western Ave
Park Ridge, IL 60068-1233
Phone (847) 825-5531

18 W140 Butterfield Rd
Suite 1558
Oakbrook Terrace, IL 60181-4843
Phone (904) 490-0264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiorenal Therapeutics of Illinois PLLC CurrentSince Dec 23, 2024 Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince Dec 12, 2022 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

4815 S Western Blvd
Chicago, IL 60609
Phone (312) 380-1379

9300 W Ballard Rd
Des Plaines, IL 60016
Phone (847) 294-2300

6601 W Touhy Ave
Niles, IL 60714
Phone (773) 217-0099

1601 N Western Ave
Park Ridge, IL 60068
Phone (773) 960-1163

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1982313318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W MILLERS RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162844",
            "telephone_number": "773-559-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W MILLERS RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162844",
            "telephone_number": "773-559-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDAGWUA",
        "first_name": "JUDE",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.