Healthcare Provider Details

I. General information

NPI: 1942347075
Provider Name (Legal Business Name): ERYTHRO MEDICAL & URGENT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 EAST 103 STREET
CHICAGO IL
60628-2713
US

IV. Provider business mailing address

PO BOX 286057
CHICAGO IL
60628-2713
US

V. Phone/Fax

Practice location:
  • Phone: 773-660-1635
  • Fax: 773-660-1638
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01047948A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01047948A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01047948A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. OLUKAYODE OLOWE
Title or Position: PRESIDENT & MEDICAL DIRECTOR
Credential: MD PHD
Phone: 773-660-1635