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

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: July 19, 2026.

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
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

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.

Nurse Practitioner (Neonatal)
611 W PARK ST
URBANA, IL 61801
Emergency Medicine
611 W PARK ST
URBANA, IL 61801
Emergency Medicine
611 W PARK ST
URBANA, IL 61801
Internal Medicine
611 W PARK ST
URBANA, IL 61801
Physician Assistant
611 W PARK ST
URBANA, IL 61801
Clinical Nurse Specialist
611 W PARK ST
URBANA, IL 61801
Registered Nurse (Critical Care Medicine)
611 W PARK ST
URBANA, IL 61801
Pharmacy
611 W PARK ST
URBANA, IL 61801

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1992699094, enumerated as an "individual" on June 04, 2025.

The provider is located at 611 W PARK ST URBANA, IL 61801 and the phone number is (217) 383-4229.

Psychiatry & Neurology with taxonomy code 2084P0800X and a focus in Psychiatry.