Provider Demographics
NPI:1962697250
Name:OKPALIKE, MARTIN NNAEMEKA (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:NNAEMEKA
Last Name:OKPALIKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 N COUNTRY CLUB CT
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-2567
Mailing Address - Country:US
Mailing Address - Phone:217-876-3161
Mailing Address - Fax:
Practice Address - Street 1:2980 N MAIN ST
Practice Address - Street 2:STE 2
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526
Practice Address - Country:US
Practice Address - Phone:217-876-8000
Practice Address - Fax:217-791-5855
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064107A208000000X, 208M00000X
NJ25MA08308100208000000X
NC2014-00844208000000X
IL036120153208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist