Provider Demographics
NPI:1528423019
Name:OYIBE, CHRISTIAN B
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:B
Last Name:OYIBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2158 45TH ST # 519
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-3742
Mailing Address - Country:US
Mailing Address - Phone:855-276-5212
Mailing Address - Fax:888-668-6550
Practice Address - Street 1:9750 CRESCENT PARK CIR UNIT 129
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-7500
Practice Address - Country:US
Practice Address - Phone:708-770-6228
Practice Address - Fax:708-249-6343
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013679363L00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277000852OtherSTATE LICENSE