IVY OBONYO
NPI 1740915503
Student in an Organized Health Care Education/Training Program in Chicago, IL

Q: What is Ivy Obonyo's NPI number?

The NPI number for Ivy Obonyo is 1740915503. It was assigned to this individual provider in the NPPES registry on July 17, 2022.

Q: What is Ivy Obonyo's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Ivy Obonyo was last updated on July 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 17, 2022PECOS Enrolled

1853 W POLK ST, CHICAGO, IL 60612(443) 207-1914 Get Directions Write a Review

NPPES record last updated: July 17, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ivy Obonyo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVY OBONYO (NPI 1740915503) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740915503

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameIVY OBONYO

Location Address1853 W POLK STChicago, IL 60612-4355

Mailing Address1853 W Polk StChicago, IL 60612-4355 · (443) 207-1914

Phone(443) 207-1914

Sole ProprietorYes

Enumeration DateJuly 17, 2022

NPPES CertifiedJuly 17, 2022

✔ NPI 1740915503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1853 W POLK ST, Chicago, IL 60612

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ivy Obonyo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JUNYUN PARK

Student in an Organized Health Care Education/Training Program