MEDICARE: NNEKA IFEOMA OKAGBUE APRN

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	363LF0000X	Family Nurse Practitioner	71017958A	IN
2	363LF0000X	Family Nurse Practitioner	209.029027	IL

General Provider Information

NPI Number	:	1457129272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NNEKA IFEOMA OKAGBUE APRN

Provider Business Mailing Address
First Line	:	7343 MARSHALL AVE
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-2653
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5736 W NORTH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-4152
Country	:	US
Telephone Number	:	773-385-9850
Fax Number	:

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

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	04/23/2026

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