KANAYO K ODELUGA (NPI# 1023173895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023173895 |
| Entity Type | Individual |
| Full Name | KANAYO K ODELUGA |
| Credential | MD, MPH |
| Practice Address |
915 W Chicago Ave East Chicago IN 46312 |
| Mailing Address |
915 W Chicago Ave East Chicago IN 46312-3308 |
| Practice Telephone | 2193976000 |
| Practice Fax Number | 2193976358 |
| Mailing Telephone | 2193976000 |
| Mailing Fax Number | 2193976358 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2013-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036092504 | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 01047947 | IN | Allopathic & Osteopathic Physicians |
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
036092504 | IL | Allopathic & Osteopathic Physicians |
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
01047947 | IN | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 036092504 | IL | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 01047947 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQH | 10593989 | 01 | |
| PALMETTO GBA MEDI | 080148350 | 01 | |
| IN | 200195020 | 05 | |
| ANTHEM BCBS | 000000D93250 | 01 | |
| IN | LICENSING BOARD | 01047947 | 01 |
| IL | IL DEPT OF HEALTHCARE & F | 036092504 | 01 |
| Street Address |
915 W CHICAGO AVE |
| City | EAST CHICAGO |
| State | IN |
| Zip Code | 46312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043375934 | Chikare Health Services Inc | Clinic/Center | 915 W Chicago Ave, East Chicago, IN 46312 | 2006-12-22 |
| 1285298067 | Chikare Health System PC | Clinic/Center | 915 W Chicago Ave, East Chicago, IN 46312-3308 | 2019-04-26 |
| 1720405228 | Irene Odeluga | Nurse Practitioner | 915 W Chicago Ave, East Chicago, IN 46312-3308 | 2014-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578025896 | 219 Health Network Inc | Clinic/Center | 4320 First Street, Suite 211, East Chicago, IN 46312 | 2019-04-04 |
| 1932663051 | Melissa Lynn Del Rosario | Registered Nurse | St. Catherine Hospital, 4321 Fir St, East Chicago, IN 46312 | 2019-01-23 |
| 1851896013 | Scot Eric West | Registered Nurse | 4320 Fir St Unit 217, East Chicago, IN 46312 | 2018-03-28 |
| 1528598380 | Wellnes for Life | Clinic/Center | 1401 144th St, East Chicago, IN 46312 | 2017-06-14 |
| 1992116305 | Familia Dental Ec LLC | Dentist | 4624a Magoun Avenue, East Chicago, IN 46312 | 2014-05-20 |
| 1821415076 | Ericka Rouse | Counselor | 901 West Chicago Ave., East Chicago, IN 46312 | 2014-03-26 |
| 1568806057 | St. Catherine Hospital Inc. | Pharmacy | 4321 Fir St., East Chicago, IN 46312 | 2013-04-26 |
| 1275882185 | Planned Parenthood of Indiana East Chicago | Clinic/Center | 3931 Main Street, East Chicago, IN 46312 | 2012-09-06 |
| 1851417356 | Deborah Ann Duda | Nurse Practitioner | 1155 E Alexis, Toledo, OH 46312 | 2007-03-22 |
| 1255457826 | Major Hospital | Skilled Nursing Facility | 5025 Mccook Ave, East Chicago, IN 46312 | 2007-03-22 |
| Find all providers in zip 46312 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285795708 | Alberto A Jimenez | General Practice | 4035 Elm St, East Chicago, IN 46312 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083235188 | Bonzer Medical, LLC | General Practice | 4423 S County Road 125 E, Greencastle, IN 46135-9237 | 2020-04-29 |
| 1851911945 | Regen 360 Indy LLC | General Practice | 70 E 91st St Ste 101, Indianapolis, IN 46240-1550 | 2020-04-20 |
| 1053946293 | Youhealth, Inc. | General Practice | 9515 Ledge Wood Ct, Fort Wayne, IN 46804-4701 | 2020-03-09 |
| 1194359240 | Mh Nursing of Indiana, PC | General Practice | 10090 Georgia St, Crown Point, IN 46307-6526 | 2020-02-27 |
| 1871130815 | Michael Staub | General Practice | 3263 S 3rd Pl, Terre Haute, IN 47802-3765 | 2019-12-10 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1871074732 | Healthy Schools Indiana LLC | General Practice | 6605 E State Blvd Ste 9, Fort Wayne, IN 46815-7036 | 2018-08-28 |
| 1518445089 | Allied Wellness Group | General Practice | 8202 Clearvista Pkwy Ste 9f, Indianapolis, IN 46256-1457 | 2018-08-06 |
| 1114405008 | People Nurturing People, Inc | General Practice | 3640 Watson Rd, Indianapolis, IN 46205-3562 | 2018-08-01 |
| 1215433420 | Sean Andrew Koerner | General Practice | 9465 Counselors Row Ste 200, Indianapolis, IN 46240-3817 | 2018-04-05 |
| Find all providers with the same taxonomy | ||||
| City | EAST CHICAGO |
| Zip Code | 46312 |
Please comment or provide details below to improve the information on KANAYO K ODELUGA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.