Look up the most recent NPI and PECOS records

Quincy Ogbogu

Radiology

Allopathic & Osteopathic Physicians

PECOS Enrollment

Based on the most recent information from CMS, provider Quincy Ogbogu is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 7 days ago.

Profile Details

Provider ID
1689255325
Provider Type
Individual
Full Name
Ogbogu, Quincy
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
4/15/2021
Last Updated
12/14/2024

Contact Information

Practice Location

2610 S. 1st Avenue, Maywood, IL 60153

(888) 584-7888

Unlisted Fax

Mailing Location

2610 S. 1st Avenue, Maywood, IL 60153

(888) 584-7888

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 036171440 Illinois
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 125077608 Illinois
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Quincy Ogbogu

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Ibrahim, Nevein F

Bova, Davide

Poccia, Julia

Yacoub, Joseph

Patel, Anand

Kral, Madonna

Mosenthal, Mckenzie

Mirowitz, Scott Alan

Mullen, Sheila

Gjeluci, Albert