Provider Demographics
NPI:1619111432
Name:ONYEJIAKA, NDIDI (MD)
Entity Type:Individual
Prefix:DR
First Name:NDIDI
Middle Name:
Last Name:ONYEJIAKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-3357
Mailing Address - Country:US
Mailing Address - Phone:312-283-3456
Mailing Address - Fax:312-380-0153
Practice Address - Street 1:8 S MICHIGAN AVE
Practice Address - Street 2:SUITE 2500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3357
Practice Address - Country:US
Practice Address - Phone:312-283-3456
Practice Address - Fax:312-380-0153
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1350512084P0804X, 2084S0010X, 2084P0800X, 208000000X
LAMD.2049792084P0800X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports Medicine
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1885312Medicaid