Provider Demographics
NPI:1609886860
Name:OAKLUND MEDICAL GROUP, LTD
Entity Type:Organization
Organization Name:OAKLUND MEDICAL GROUP, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:EGEKEZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-515-2200
Mailing Address - Street 1:5480 ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-6211
Mailing Address - Country:US
Mailing Address - Phone:815-477-7800
Mailing Address - Fax:815-477-7812
Practice Address - Street 1:12151 REGENCY PKWY # 12173
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-7644
Practice Address - Country:US
Practice Address - Phone:847-515-2200
Practice Address - Fax:847-515-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100558Medicaid
IL04532115OtherBLUE CROSS/SHIELD
ILDG3054OtherRAIL ROAD MEDICARE
IL200997Medicare PIN
ILDG3054OtherRAIL ROAD MEDICARE