Provider Demographics
NPI:1356309421
Name:OLEKANMA, UCHENNA (MD)
Entity Type:Individual
Prefix:DR
First Name:UCHENNA
Middle Name:
Last Name:OLEKANMA
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 1:8201 S ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-4626
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8201 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-4626
Practice Address - Country:US
Practice Address - Phone:773-873-3434
Practice Address - Fax:773-873-0208
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036114328207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL033607536OtherPUBLIC AID
IL5566-0185OtherILLINOIS IBT
261165238OtherTAX PRACTICE ID
IL1356309421OtherNPI NUMBER
IL01623046OtherBCBS PROVIDER NUMBER
IL01623046OtherBCBS PROVIDER NUMBER
IL5566-0185OtherILLINOIS IBT