Provider Demographics
NPI:1992815088
Name:OKAI, SOLOMON OKOE (MD)
Entity type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:OKOE
Last Name:OKAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SOLOMON
Other - Middle Name:
Other - Last Name:OKAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6429 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302
Mailing Address - Country:US
Mailing Address - Phone:708-763-8334
Mailing Address - Fax:708-763-8334
Practice Address - Street 1:6429 NORTH AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1028
Practice Address - Country:US
Practice Address - Phone:708-763-8334
Practice Address - Fax:708-763-8334
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036067387207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01621468OtherBLUECROSS/BLUESHIELD
IL315680Medicare ID - Type Unspecified
IL01621468OtherBLUECROSS/BLUESHIELD
IL036067387Medicare ID - Type Unspecified
E18398Medicare UPIN