MEDICARE: DR. UCHENNA OLEKANMA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036114328	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	033607536	OTHER	IL	PUBLIC AID
2	5566-0185	OTHER	IL	ILLINOIS IBT
3	261165238	OTHER		TAX PRACTICE ID
4	1356309421	OTHER	IL	NPI NUMBER
5	01623046	OTHER	IL	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1356309421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. UCHENNA OLEKANMA M.D.

Provider Business Mailing Address
First Line	:	8201 S ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-4626
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8201 S ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-4626
Country	:	US
Telephone Number	:	773-873-3434
Fax Number	:	773-873-0208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	03/07/2023

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