Kanayo K Odeluga
Internist General Practice Physician
915 W Chicago Ave
East Chicago
, Indiana 46312
Kanayo K Odeluga
Internist General Practice Physician
915 W Chicago Ave
East Chicago
, Indiana 46312
(219) 397-6358
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About
Features
Specialties
- Internist
- General Practice Physician
Languages spoken
- English
Location
First Address
- Kanayo K Odeluga
- 915 W Chicago Ave
- East Chicago, IN
- Zip : 46312-3308
- Fax : (219) 397-6358
- Phone : (219) 397-6000
Second Address
- Kanayo K Odeluga
- 915 W Chicago Ave
- East Chicago, IN
- Zip : 46312
- Fax : (219) 397-6358
- Phone : (219) 397-6000
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Where is Kanayo K Odeluga ’s practice located?
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Is Kanayo K Odeluga a sole practitioner?
Is Kanayo K Odeluga accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 01047947 | IN |
| N | 111NI0900X | Internist | 01047947 | IN |
| N | 207R00000X | Internist | 036092504 | IL |
| N | 111NI0900X | Internist | 036092504 | IL |
| Y | 208D00000X | General Practice Physician | 01047947 | IN |
| N | 208D00000X | General Practice Physician | 036092504 | IL |
National Provider Identifier
| NPI | 1023173895 |
|---|---|
| Provider Name | Kanayo K Odeluga |
| First Address | East Chicago, IN 46312-3308 |
| Second Address | East Chicago, IN 46312 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/12/2006 |
| Last Update Date | 21/03/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000D93250 | ANTHEM BCBS (01) | |
| 01047947 | LICENSING BOARD (01) | IN |
| 036092504 | IL DEPT OF HEALTHCARE & F (01) | IL |
| 080148350 | PALMETTO GBA MEDI (01) | |
| 10593989 | CAQH (01) | |
| 200195020 | (05) | IN |
| G43801 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.