Individual
DR. PATIENCE OKPAKU ADESIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2008 N MARKET ST, CHAMPAIGN, IL 61822-1308
(217) 239-6667
(217) 239-6670
Mailing address
2008 N MARKET ST, CHAMPAIGN, IL 61822-1308
(217) 239-6667
(217) 239-6670
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036075310
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01027388
BLUE CROSS BLUE SHIELD
IL
05
—
036075310
—
IL
01
—
173634
PERSONAL CARE HMO
IL
Enumeration date
08/24/2006
Last updated
08/27/2013
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