Provider Demographics
NPI:1245588680
Name:OKAFOR, LOUIS C (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:C
Last Name:OKAFOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 S SOUTH SHORE DR APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41 STEWART ST
Practice Address - Street 2:APARTMENT A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2822
Practice Address - Country:US
Practice Address - Phone:405-314-7809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018016207207X00000X
390200000X
OH35.139213207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0411473Medicaid