DR. ETINOSA ANN IDEMUDIA MD
NPI 1992699094
Psychiatry & Neurology - Psychiatry in Urbana, IL

Q: What is Etinosa Idemudia's NPI number?

The NPI number for Etinosa Idemudia is 1992699094. It was assigned to this individual provider in the NPPES registry on June 4, 2025.

Q: What is Etinosa Idemudia's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Etinosa Idemudia was last updated on June 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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 June 04, 2025

611 W PARK ST, URBANA, IL 61801(217) 383-4229 Get Directions Write a Review

NPPES record last updated: June 4, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Etinosa Ann Idemudia Md NPPES

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

DR. ETINOSA ANN IDEMUDIA MD (NPI 1992699094) is an individual psychiatry provider in Urbana, Illinois, licensed in Illinois (125.086201) and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1992699094

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameDR. ETINOSA ANN IDEMUDIACredential: MD

Location Address611 W PARK STUrbana, IL 61801-2501

Mailing Address5209 Foggia AveLas Vegas, NV 89130-7059 · (862) 262-6012

Phone(217) 383-4229

Sole ProprietorYes

Enumeration DateJune 4, 2025

NPPES CertifiedJune 4, 2025

✔ NPI 1992699094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in IL · 125.086201

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

611 W PARK ST, Urbana, IL 61801

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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.

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611 W PARK ST, HVI
URBANA, IL 61801

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